MEDICARE: MICHAEL BADILLO 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

General Provider Information

NPI Number	:	1821720053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BADILLO BCBA

Provider Business Mailing Address
First Line	:	350 FAIRWAY DR STE 101
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1834
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1606 W SWISHER PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-3400
Country	:	US
Telephone Number	:	562-417-3374
Fax Number	:

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

Provider Enumeration Date	:	06/27/2022
Last Update Date	:	05/28/2026

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