MEDICARE: WILLIAM PASSINO

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

General Provider Information

NPI Number	:	1538815923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM PASSINO

Provider Business Mailing Address
First Line	:	10850 NW 17TH CT
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33026-2202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1790 SW 43RD WAY
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33317-5701
Country	:	US
Telephone Number	:	954-584-8000
Fax Number	:

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

Provider Enumeration Date	:	02/24/2022
Last Update Date	:	02/24/2022

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Directions to “ WILLIAM PASSINO ” Practice Location

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