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NPI Code Detail

MEDICARE: MYRELLA LIZETH CUELLAR

MEDICARE: MYRELLA LIZETH CUELLAR
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
1106S00000XBehavior TechnicianRBT-18-52810FL
2106S00000XBehavior TechnicianHI

General Provider Information

NPI Number : 1528564648
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRELLA LIZETH CUELLAR
Provider Business Mailing Address
First Line : 3771 STEFANI RD
Second Line :
City : CANTONMENT
State : FL
Zip : 32533-7795
Country : US
Telephone Number : 850-607-6910
Fax Number : 850-607-6932
Provider Business Practice Location Address
First Line : 1390 MILLER ST
Second Line :
City : HONOLULU
State : HI
Zip : 96813-2493
Country : US
Telephone Number : 808-784-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2018
Last Update Date : 08/23/2024

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Directions to “ MYRELLA LIZETH CUELLAR ” Practice Location

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