MEDICARE: SARAH A. PERRUCCIO 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
2	103K00000X	Behavior Analyst	1-15-20013

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	:	1700199395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH A. PERRUCCIO BCBA

Provider Business Mailing Address
First Line	:	3300 26TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-2730
Country	:	US
Telephone Number	:	860-930-8644
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 4TH ST N STE 318
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	727-327-5222
Fax Number	:

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

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	10/05/2021

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