Ma. de Jesus Bautista

Individual provider Active NPI Developmental Therapist · Seffner, FL

NPI 1376216754 · NPPES record last updated Jul 30, 2021

Key facts

NPI
1376216754
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
11722 Lynn Brook Cir
Seffner, FL 33584-7203
Phone
(813) 484-2314
Fax
(813) 433-5163
NPI assigned
Jul 30, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Development First. Corp Current
since Aug 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

11722 Lynn Brook Cir
Seffner, FL 33584-7203

Mailing address

11722 Lynn Brook Cir
Seffner, FL 33584-7203
Phone (813) 484-2314

Other providers in Seffner, FL

All providers in Seffner, FL · Developmental Therapist in Florida

Sources for this page

Verify at the official NPI Registry.