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NPI Code Detail

MEDICARE: ANNETTE VICTORIA ELGUEZABAL BCBA

MEDICARE: ANNETTE VICTORIA ELGUEZABAL BCBA
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 Analyst01910171FL
2106E00000XAssistant Behavior Analyst0-19-10171FL
3106E00000XAssistant Behavior Analyst
4103K00000XBehavior Analyst1-22-62950FL

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 : 1578199063
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNETTE VICTORIA ELGUEZABAL BCBA
Provider Business Mailing Address
First Line : 5113 PARK CENTRAL DR APT 711
Second Line :
City : ORLANDO
State : FL
Zip : 32839-5365
Country : US
Telephone Number : 305-965-6979
Fax Number :
Provider Business Practice Location Address
First Line : 13538 VILLAGE PARK DR STE 145
Second Line :
City : ORLANDO
State : FL
Zip : 32837-3600
Country : US
Telephone Number : 407-730-2948
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2020
Last Update Date : 12/14/2022

Similar Medicare Providers

1528796158 — STEPHANY GUERRERO
Practice Location Address:
13538 VILLAGE PARK DR UNIT 145
ORLANDO, FL
32837-3600
Practice Phone: 407-730-2948
Practice Fax:
1932716107 — JENNIFER LISA SCOTT
Practice Location Address:
13538 VILLAGE PARK DR STE 145
ORLANDO, FL
32837-3600
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Practice Fax: 407-250-4833
1851999460 — LEAH MARTIN M.A., BCBA
Practice Location Address:
13538 VILLAGE PARK DR STE 145
ORLANDO, FL
32837-3600
Practice Phone: 407-730-2948
Practice Fax:
1285382135 — SORAIMA SEGARRA
Practice Location Address:
13538 VILLAGE PARK DR STE 145
ORLANDO, FL
32837-3600
Practice Phone: 407-730-2948
Practice Fax:
1497403299 — RACHEL LORETZ
Practice Location Address:
13538 VILLAGE PARK DR STE 145
ORLANDO, FL
32837-3600
Practice Phone: 407-250-4833
Practice Fax:
1619625076 — EVERGAIL QUINTERO
Practice Location Address:
13538 VILLAGE PARK DR STE 145
ORLANDO, FL
32837-3600
Practice Phone: 407-730-2948
Practice Fax:

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