MEDICARE: MS. BILLIE IRENE O'CONNOR BCABA

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	106E00000X	Assistant Behavior Analyst	0-09-3010	FL

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	:	1730344649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BILLIE IRENE O'CONNOR BCABA

Provider Business Mailing Address
First Line	:	500 E COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4504
Country	:	US
Telephone Number	:	407-218-4340
Fax Number	:	407-218-4303

Provider Business Practice Location Address
First Line	:	500 E COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4504
Country	:	US
Telephone Number	:	407-218-4340
Fax Number	:	407-218-4303

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

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	12/06/2018

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