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NPI Code Detail

MEDICARE: DELFINA LILIA LEDESMA ESTUPINAN

MEDICARE: DELFINA LILIA LEDESMA ESTUPINAN
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
2103K00000XBehavior Analyst1-21-51732FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-21-51732OTHERFLBCBA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982349759
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELFINA LILIA LEDESMA ESTUPINAN
Provider Business Mailing Address
First Line : 139 MARINER LN
Second Line :
City : ROTONDA WEST
State : FL
Zip : 33947-2025
Country : US
Telephone Number : 786-234-4618
Fax Number :
Provider Business Practice Location Address
First Line : 5051 MEMORIAL HWY
Second Line :
City : TAMPA
State : FL
Zip : 33634-7355
Country : US
Telephone Number : 813-290-0779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2022
Last Update Date : 04/08/2025

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Directions to “ DELFINA LILIA LEDESMA ESTUPINAN ” Practice Location

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