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NPI Code Detail

MEDICARE: DOMINIQUE MARIE ORDON

MEDICARE: DOMINIQUE MARIE ORDON
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 TechnicianLA

General Provider Information

NPI Number : 1891567301
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIQUE MARIE ORDON
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 : 877-741-8297
Fax Number : 866-500-2186
Provider Business Practice Location Address
First Line : 4202 N 1-10 SERVICE RD W
Second Line :
City : METAIRE
State : LA
Zip : 70006
Country : US
Telephone Number : 504-444-9664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2023
Last Update Date : 10/27/2023

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Directions to “ DOMINIQUE MARIE ORDON ” 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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