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NPI Code Detail

MEDICARE: MICHAEL INIGUEZ

MEDICARE: MICHAEL INIGUEZ
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 TechnicianCO

General Provider Information

NPI Number : 1902668585
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL INIGUEZ
Provider Business Mailing Address
First Line : 2120 E LA SALLE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-2218
Country : US
Telephone Number : 719-466-4809
Fax Number : 719-368-8399
Provider Business Practice Location Address
First Line : 1511 SWOPE AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-2846
Country : US
Telephone Number : 719-466-4809
Fax Number : 719-368-8399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2024
Last Update Date : 01/29/2024

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Directions to “ MICHAEL INIGUEZ ” Practice Location

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