MEDICARE: VICTORIA WHITE

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	1523153	FL

General Provider Information

NPI Number	:	1578408241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA WHITE

Provider Business Mailing Address
First Line	:	11322 CURIO DR
Second Line	:
City	:	BROOKSVILLE
State	:	FL
Zip	:	34613-1212
Country	:	US
Telephone Number	:	352-810-0395
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-5691
Country	:	US
Telephone Number	:	352-810-0395
Fax Number	:

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

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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Directions to “ VICTORIA WHITE ” Practice Location

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