MEDICARE: MARIELA TRIGUERO SUAREZ

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	RBT-20-129997

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	:	1477132942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIELA TRIGUERO SUAREZ

Provider Business Mailing Address
First Line	:	5970 HILLYER CT
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-4515
Country	:	US
Telephone Number	:	786-343-0436
Fax Number	:

Provider Business Practice Location Address
First Line	:	5970 HILLYER CT
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-4515
Country	:	US
Telephone Number	:	786-343-0436
Fax Number	:

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

Provider Enumeration Date	:	04/03/2021
Last Update Date	:	02/25/2022

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Directions to “ MARIELA TRIGUERO SUAREZ ” Practice Location

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