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NPI Code Detail

MEDICARE: ANDREA JUANA FOURCADE

MEDICARE:   ANDREA JUANA FOURCADE
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
1224Z00000XOccupational Therapy AssistantCOTA13373FL
2103K00000XBehavior Analyst1-21-55270FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427458801
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA JUANA FOURCADE
Provider Business Mailing Address
First Line : 9697 SW 147TH CT
Second Line :
City : MIAMI
State : FL
Zip : 33196-1677
Country : US
Telephone Number : 786-985-0667
Fax Number :
Provider Business Practice Location Address
First Line : 9697 SW 147TH CT
Second Line :
City : MIAMI
State : FL
Zip : 33196-1677
Country : US
Telephone Number : 786-985-0667
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2014
Last Update Date : 04/26/2022

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Directions to “ ANDREA JUANA FOURCADE ” Practice Location

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