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NPI Code Detail

MEDICARE: FAITH ELIZABETH REALE

MEDICARE: FAITH ELIZABETH REALE
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 TechnicianVA

General Provider Information

NPI Number : 1861335986
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAITH ELIZABETH REALE
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-244-1818
Fax Number :
Provider Business Practice Location Address
First Line : 3855 CENTERVIEW DR STE 400B
Second Line :
City : CHANTILLY
State : VA
Zip : 20151-3285
Country : US
Telephone Number : 571-554-5730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ FAITH ELIZABETH REALE ” Practice Location

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