MEDICARE: JANNA MELANIE PENA RBT

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	106S00000X	Behavior Technician	RBT-26-521681	NY

General Provider Information

NPI Number	:	1447108873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANNA MELANIE PENA RBT

Provider Business Mailing Address
First Line	:	6901 PROFESSIONAL PKWY STE 200
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8473
Country	:	US
Telephone Number	:	888-720-2095
Fax Number	:	813-723-1260

Provider Business Practice Location Address
First Line	:	2555 OCEAN AVE STE 206
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4585
Country	:	US
Telephone Number	:	888-720-2095
Fax Number	:	813-723-1260

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

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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