MEDICARE: SANDRA HERRERA

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	106S00000X	Behavior Technician		FL
2	103K00000X	Behavior Analyst

Other Identifiers

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

General Provider Information

NPI Number	:	1861927600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA HERRERA

Provider Business Mailing Address
First Line	:	1117 NW 136TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33182-2613
Country	:	US
Telephone Number	:	305-215-7087
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 NW 136TH CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33182-2613
Country	:	US
Telephone Number	:	305-215-7087
Fax Number	:

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

Provider Enumeration Date	:	05/01/2017
Last Update Date	:	05/02/2024

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Directions to “ SANDRA HERRERA ” Practice Location

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