MEDICARE: RITA MARIA CABALLERO

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	106S00000X	Behavior Technician		FL

General Provider Information

NPI Number	:	1336970425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA MARIA CABALLERO

Provider Business Mailing Address
First Line	:	5508 NW E TORINO PKWY APT 111
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-4603
Country	:	US
Telephone Number	:	973-336-9073
Fax Number	:

Provider Business Practice Location Address
First Line	:	5508 NW E TORINO PKWY APT 111
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34986-4603
Country	:	US
Telephone Number	:	973-336-9073
Fax Number	:

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

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	08/09/2024

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Directions to “ RITA MARIA CABALLERO ” Practice Location

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