Provider Demographics
NPI:1336691773
Name:PULIDO, NATALIE RUTH (BCABA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:RUTH
Last Name:PULIDO
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 NW 76TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-6668
Mailing Address - Country:US
Mailing Address - Phone:352-505-6363
Mailing Address - Fax:352-332-8589
Practice Address - Street 1:2035 SW 75TH ST STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-3425
Practice Address - Country:US
Practice Address - Phone:877-823-4283
Practice Address - Fax:352-332-8589
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst