MEDICARE: MARIBEL MENENDEZ HUERGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst	0-20-11548	FL

General Provider Information

NPI Number	:	1043705858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIBEL MENENDEZ HUERGO

Provider Business Mailing Address
First Line	:	2530 W 60TH PL UNIT 104-17
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-4353
Country	:	US
Telephone Number	:	786-333-4978
Fax Number	:

Provider Business Practice Location Address
First Line	:	2530 W 60TH PL UNIT 104-17
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-4353
Country	:	US
Telephone Number	:	786-333-4978
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	10/31/2025

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