MEDICARE: MEGAN RAGOSTA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679013981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN RAGOSTA

Provider Business Mailing Address
First Line	:	13525 BARTRAM PARK BLVD UNIT 135
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-5243
Country	:	US
Telephone Number	:	904-403-5534
Fax Number	:

Provider Business Practice Location Address
First Line	:	4647 CLYDE MORRIS BLVD UNIT 501
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32129-3001
Country	:	US
Telephone Number	:	386-290-6073
Fax Number	:

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

Provider Enumeration Date	:	03/06/2017
Last Update Date	:	08/09/2024

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Directions to “ MEGAN RAGOSTA ” Practice Location

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