Provider Demographics
NPI:1265119135
Name:SCARNECCHIA, ROSARIE TERESITA
Entity type:Individual
Prefix:
First Name:ROSARIE
Middle Name:TERESITA
Last Name:SCARNECCHIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSARIE
Other - Middle Name:TERESITA
Other - Last Name:UDOUJ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:300 INTERNATIONAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5028
Mailing Address - Country:US
Mailing Address - Phone:866-610-0580
Mailing Address - Fax:
Practice Address - Street 1:5220 LEE BLVD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1036
Practice Address - Country:US
Practice Address - Phone:239-932-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician