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NPI Code Detail

MEDICARE: CLARISSA VENEZUELA

MEDICARE: CLARISSA VENEZUELA
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1588398275
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARISSA VENEZUELA
Provider Business Mailing Address
First Line : 1000 WOODCOCK RD STE 100
Second Line :
City : ORLANDO
State : FL
Zip : 32803-3653
Country : US
Telephone Number : 407-550-8696
Fax Number :
Provider Business Practice Location Address
First Line : 1000 WOODCOCK RD STE 100
Second Line :
City : ORLANDO
State : FL
Zip : 32803-3653
Country : US
Telephone Number : 407-550-8696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2022
Last Update Date : 07/11/2022

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Directions to “ CLARISSA VENEZUELA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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