MEDICARE: KYRA DEBARDELEBEN

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

General Provider Information

NPI Number	:	1922977602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA DEBARDELEBEN

Provider Business Mailing Address
First Line	:	6061 N FALLS CIRCLE DR APT 302
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33319-6835
Country	:	US
Telephone Number	:	561-888-3187
Fax Number	:

Provider Business Practice Location Address
First Line	:	8305 NW 38TH CT
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-2907
Country	:	US
Telephone Number	:	561-888-3187
Fax Number	:

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

Provider Enumeration Date	:	11/01/2025
Last Update Date	:	11/01/2025

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Directions to “ KYRA DEBARDELEBEN ” Practice Location

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