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NPI Code Detail

MEDICARE: CIERA ANGELA MINTZ

MEDICARE:   CIERA ANGELA MINTZ
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 Technician

General Provider Information

NPI Number : 1962261735
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIERA ANGELA MINTZ
Provider Business Mailing Address
First Line : 5137 PANTHER DR
Second Line :
City : SPRING HILL
State : FL
Zip : 34607-2402
Country : US
Telephone Number : 267-586-8447
Fax Number :
Provider Business Practice Location Address
First Line : 5137 PANTHER DR
Second Line :
City : SPRING HILL
State : FL
Zip : 34607-2402
Country : US
Telephone Number : 126-758-6844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2024
Last Update Date : 03/15/2024

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Directions to “ CIERA ANGELA MINTZ ” Practice Location

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