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NPI Code Detail

MEDICARE: MISS MIA ROSE FACIONE

MEDICARE: MISS MIA ROSE FACIONE
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 Technician

General Provider Information

NPI Number : 1821791377
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MIA ROSE FACIONE
Provider Business Mailing Address
First Line : 6227 21ST AVE N
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33710-4801
Country : US
Telephone Number : 727-404-2921
Fax Number :
Provider Business Practice Location Address
First Line : 10901 ROOSEVELT BLVD N STE 100
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33716-2305
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2023
Last Update Date : 03/23/2023

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Directions to “ MISS MIA ROSE FACIONE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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