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NPI Code Detail

MEDICARE: LISANDRA JUDITH BAUTA CUBENAS

MEDICARE: LISANDRA JUDITH BAUTA CUBENAS
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 TechnicianFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992421515
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISANDRA JUDITH BAUTA CUBENAS
Provider Business Mailing Address
First Line : 7136 SW 103RD PL
Second Line :
City : MIAMI
State : FL
Zip : 33173-1377
Country : US
Telephone Number : 786-470-4624
Fax Number :
Provider Business Practice Location Address
First Line : 7136 SW 103RD PL
Second Line :
City : MIAMI
State : FL
Zip : 33173-1377
Country : US
Telephone Number : 786-470-4624
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2022
Last Update Date : 10/14/2022

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Directions to “ LISANDRA JUDITH BAUTA CUBENAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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