MEDICARE: JARIN TSUYOSHI IWATA BCBA, LBA

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	BA-998	HI

General Provider Information

NPI Number	:	1508511874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARIN TSUYOSHI IWATA BCBA, LBA

Provider Business Mailing Address
First Line	:	4200 W CYPRESS ST STE 550
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-4285
Country	:	US
Telephone Number	:	866-468-6471
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-4098 HIKUONO ST UNIT 26
Second Line	:
City	:	KAPOLEI
State	:	HI
Zip	:	96707-3421
Country	:	US
Telephone Number	:	808-349-7957
Fax Number	:	808-349-7957

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

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	11/13/2025

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