Provider Demographics
NPI:1518525898
Name:LLAGUNO, JOSE RAUL (BCBA)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RAUL
Last Name:LLAGUNO
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2882 W 72ND TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5389
Mailing Address - Country:US
Mailing Address - Phone:239-201-9338
Mailing Address - Fax:
Practice Address - Street 1:2882 W 72ND TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-5389
Practice Address - Country:US
Practice Address - Phone:239-201-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-48798103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst