MEDICARE: LEXI J SIBERT 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
1	103K00000X	Behavior Analyst		FL

General Provider Information

NPI Number	:	1649662420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEXI J SIBERT BCBA

Provider Business Mailing Address
First Line	:	3101 SW 97TH ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34476-7492
Country	:	US
Telephone Number	:	526-938-7983
Fax Number	:	321-241-1171

Provider Business Practice Location Address
First Line	:	5868 BAKER RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5903
Country	:	US
Telephone Number	:	952-767-4200
Fax Number	:	952-767-4211

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

Provider Enumeration Date	:	03/03/2015
Last Update Date	:	06/01/2023

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