MEDICARE: MANUEL S BUELGA GARCIA

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	103K00000X	Behavior Analyst	1-19-40305	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265881270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL S BUELGA GARCIA

Provider Business Mailing Address
First Line	:	1100 SW 36TH CT APT 3
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4243
Country	:	US
Telephone Number	:	786-712-5027
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 SW 36TH CT APT 3
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4243
Country	:	US
Telephone Number	:	786-712-5027
Fax Number	:

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

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	09/27/2022

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