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NPI Code Detail

MEDICARE: BEVERLY MELISCAR RBT

MEDICARE: BEVERLY MELISCAR RBT
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 TechnicianRBT-21-166706FL

General Provider Information

NPI Number : 1619541471
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY MELISCAR RBT
Provider Business Mailing Address
First Line : 11515 ROUSE RUN CIR
Second Line :
City : ORLANDO
State : FL
Zip : 32817-4551
Country : US
Telephone Number : 561-425-2644
Fax Number :
Provider Business Practice Location Address
First Line : 32 E MILLER ST
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-3570
Country : US
Telephone Number : 407-683-1072
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2021
Last Update Date : 05/17/2021

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Directions to “ BEVERLY MELISCAR RBT” Practice Location

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