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NPI Code Detail

MEDICARE: NIKOLAS ULIANOV KASAKOV

MEDICARE: NIKOLAS ULIANOV KASAKOV
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 : 1982558649
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKOLAS ULIANOV KASAKOV
Provider Business Mailing Address
First Line : 1811 WIMBLEDON ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34743-3322
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5706 N HESPERIDES ST
Second Line :
City : TAMPA
State : FL
Zip : 33614-5418
Country : US
Telephone Number : 813-629-5905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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Directions to “ NIKOLAS ULIANOV KASAKOV ” Practice Location

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