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NPI Code Detail

MEDICARE: NIEVES DE LA LLANA

MEDICARE: NIEVES DE LA LLANA
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-18-68251FL

Other Identifiers

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

General Provider Information

NPI Number : 1760989081
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIEVES DE LA LLANA
Provider Business Mailing Address
First Line : 709 BRIGGS ST APT 2
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33405-2597
Country : US
Telephone Number : 561-951-8256
Fax Number :
Provider Business Practice Location Address
First Line : 6415 LAKE WORTH RD STE 204
Second Line :
City : GREENACRES
State : FL
Zip : 33463-2904
Country : US
Telephone Number : 617-719-5615
Fax Number : 800-766-3139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2018
Last Update Date : 03/07/2024

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Directions to “ NIEVES DE LA LLANA ” Practice Location

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