MEDICARE: ASHLEY ARCE BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-25-79919	FL

General Provider Information

NPI Number	:	1417527912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ARCE BCBA

Provider Business Mailing Address
First Line	:	6032 CONDOR DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-5646
Country	:	US
Telephone Number	:	347-841-2896
Fax Number	:

Provider Business Practice Location Address
First Line	:	5628 36TH AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33710-1914
Country	:	US
Telephone Number	:	727-424-1578
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	03/18/2025

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