Provider Demographics
NPI:1891519195
Name:NORONA NORONA, EMILIO
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:NORONA NORONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 PIN CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6828
Mailing Address - Country:US
Mailing Address - Phone:305-762-0706
Mailing Address - Fax:
Practice Address - Street 1:7025 PIN CHERRY LN
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6828
Practice Address - Country:US
Practice Address - Phone:305-762-0706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-392575106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician