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NPI Code Detail

MEDICARE: MARIANA VILLEGAS BCBA

MEDICARE: MARIANA VILLEGAS 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 Analyst1-19-39808FL

General Provider Information

NPI Number : 1932640307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANA VILLEGAS 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 : 17815 HUNTING BOW CIR
Second Line :
City : LUTZ
State : FL
Zip : 33558-5401
Country : US
Telephone Number : 813-491-4425
Fax Number : 813-482-9790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2017
Last Update Date : 10/23/2023

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Directions to “ MARIANA VILLEGAS BCBA” Practice Location

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