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NPI Code Detail

MEDICARE: SELENA ANTUNEZ

MEDICARE:   SELENA  ANTUNEZ
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
1103K00000XBehavior Analyst1-23-67154
2103K00000XBehavior Analyst

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 : 1497219828
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELENA ANTUNEZ
Provider Business Mailing Address
First Line : 2410 COBBLERS LN APT D
Second Line :
City : KISSIMMEE
State : FL
Zip : 34744-5558
Country : US
Telephone Number : 407-243-7231
Fax Number :
Provider Business Practice Location Address
First Line : 4441 BRYANT IRVIN RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-7338
Country : US
Telephone Number : 817-402-8101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2019
Last Update Date : 09/29/2023

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Directions to “ SELENA ANTUNEZ ” Practice Location

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