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NPI Code Detail

MEDICARE: JANELLE KIRSTIE BACOTTI BCBA

MEDICARE: JANELLE KIRSTIE BACOTTI 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
1106E00000XAssistant Behavior Analyst0-15-6835FL
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1932568557
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANELLE KIRSTIE BACOTTI BCBA
Provider Business Mailing Address
First Line : 4101 NW 89TH BLVD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32606-3813
Country : US
Telephone Number : 407-807-7798
Fax Number :
Provider Business Practice Location Address
First Line : 1015 NW 56TH TER
Second Line :
City : GAINESVILLE
State : FL
Zip : 32605-4481
Country : US
Telephone Number : 352-835-5520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2016
Last Update Date : 05/05/2021

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