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Lisandra Ortega Fong

Behavior Analyst

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Lisandra Ortega Fong does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1831722644
Provider Type
Individual
Full Name
Ortega Fong, Lisandra
Gender
Female

Sole Proprietor
Yes
Enumeration Date
2/20/2020
Last Updated
7/10/2024

Contact Information

Practice Location

2304 W 68th St, Hialeah, FL 33016-1806

(512) 792-6672

Unlisted Fax

Mailing Location

2304 W 68th St, Hialeah, FL 33016-1806

(512) 792-6672

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103K00000X Primary	Description Behavior Analyst Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 106E00000X	Description Assistant Behavior Analyst Behavioral Health & Social Service Providers	License BCABA-0-23-14855 Florida
Code 106S00000X	Description Behavior Technician Behavioral Health & Social Service Providers	License RBT-20-111309 Florida
Code 222Q00000X	Description Developmental Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License Unlisted Issuer

Lisandra Ortega Fong

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Mastered Behavior, Inc

Parrado, Arlette Christine

Campos, Alex

Aba Center.Corp

Izquierdo, Lay

Quijano, Magdelena

Rodriguez, Leticia

Suarez, Sayli

Losanto Broceta, Meysser

Ricardo, Walter Luis