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NPI Code Detail

MEDICARE: AMY FRAZER RBT

MEDICARE: AMY FRAZER 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
1106S00000XBehavior TechnicianRBT-26-509445FL

General Provider Information

NPI Number : 1477402055
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY FRAZER RBT
Provider Business Mailing Address
First Line : 16414 LAKE CHURCH DR
Second Line :
City : ODESSA
State : FL
Zip : 33556-2637
Country : US
Telephone Number : 813-926-5454
Fax Number : 813-920-9252
Provider Business Practice Location Address
First Line : 8001 BEATY GROVE DR
Second Line :
City : TAMPA
State : FL
Zip : 33626-1602
Country : US
Telephone Number : 813-926-5454
Fax Number : 813-920-9252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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