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NPI Code Detail

MEDICARE: MS. ELIZABETH KEYES BCBA

MEDICARE: MS. ELIZABETH KEYES 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1801126321
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH KEYES BCBA
Provider Business Mailing Address
First Line : 6416 NW 5TH WAY
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-6112
Country : US
Telephone Number : 888-754-0398
Fax Number :
Provider Business Practice Location Address
First Line : 5400 S UNIVERSITY DR STE 502
Second Line :
City : DAVIE
State : FL
Zip : 33328-5313
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2010
Last Update Date : 07/20/2020

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