Individual
ANDREA LANDIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3107 N 50TH ST STE A, TAMPA, FL 33619-2302
(813) 466-2236
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/10/2020
Last updated
09/17/2021
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