Basic Information
| Provider Information | |||||||||
| NPI: | 1366987893 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUNHA | ||||||||
| FirstName: | CAITLIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6361 BAYSIDE KEY DR | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336154294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3869566210 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7777 131ST ST STE 7 | ||||||||
| Address2: | |||||||||
| City: | SEMINOLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7274925369 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2016 | ||||||||
| LastUpdateDate: | 11/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-15-09245 | FL | N | 103K00000X | 1-17-28726 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.