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NPI Code Detail

MEDICARE: MATTHEW DELANEY BCBA

MEDICARE: MATTHEW DELANEY BCBA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1932489655
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW DELANEY BCBA
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 407-915-7729
Fax Number : 407-588-6294
Provider Business Practice Location Address
First Line : 45 ALABAMA AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-2677
Country : US
Telephone Number : 904-420-2304
Fax Number : 904-508-0173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2011
Last Update Date : 10/04/2023

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