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NPI Code Detail

MEDICARE: SARAEMIS GORT CABALLERO

MEDICARE:   SARAEMIS  GORT 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1649089327
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAEMIS GORT CABALLERO
Provider Business Mailing Address
First Line : 225 E 13TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33010-3537
Country : US
Telephone Number : 786-960-7142
Fax Number :
Provider Business Practice Location Address
First Line : 225 E 13TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33010-3537
Country : US
Telephone Number : 786-960-7142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 01/06/2025

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Directions to “ SARAEMIS GORT CABALLERO ” Practice Location

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