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NPI Code Detail

MEDICARE: MICAH GARVIN BCABA

MEDICARE: MICAH GARVIN BCABA
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
1106E00000XAssistant Behavior Analyst0-24-15697

General Provider Information

NPI Number : 1891375879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICAH GARVIN BCABA
Provider Business Mailing Address
First Line : 1900 PEAK CIR
Second Line :
City : APOPKA
State : FL
Zip : 32703-8580
Country : US
Telephone Number : 407-690-6140
Fax Number :
Provider Business Practice Location Address
First Line : 1928 BOOTHE CIR
Second Line :
City : LONGWOOD
State : FL
Zip : 32750-6774
Country : US
Telephone Number : 407-434-1556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2021
Last Update Date : 03/25/2026

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