Lisandra Abdon

Individual provider Active NPI Behavior Technician · Cutler Bay, FL

NPI 1013422112 · NPPES record last updated Dec 11, 2017

Key facts

NPI
1013422112
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
19920 SW 88TH PL
Cutler Bay, FL 33157-0610
Phone
(786) 278-4170
NPI assigned
Dec 11, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

19920 SW 88TH PL
Cutler Bay, FL 33157-0610

Mailing address

19920 SW 88TH PL
Cutler Bay, FL 33157-0610
Phone (786) 278-4170

Other identifiers

IdentifierTypeStateIssuer
021973900MedicaidFL

Other providers in Cutler Bay, FL

All providers in Cutler Bay, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.