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NPI Code Detail

MEDICARE: GISELLE SUAREZ VICTORERO

MEDICARE:   GISELLE  SUAREZ VICTORERO
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

Other Identifiers

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

General Provider Information

NPI Number : 1679274625
Entity Type Code : Individual
Provider Name (Legal Business Name) : GISELLE SUAREZ VICTORERO
Provider Business Mailing Address
First Line : 3169 HYPOLUXO RD
Second Line :
City : LAKE WORTH
State : FL
Zip : 33462-3703
Country : US
Telephone Number : 786-380-9221
Fax Number :
Provider Business Practice Location Address
First Line : 3169 HYPOLUXO RD
Second Line :
City : LAKE WORTH
State : FL
Zip : 33462-3703
Country : US
Telephone Number : 786-380-9221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2023
Last Update Date : 03/21/2023

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Directions to “ GISELLE SUAREZ VICTORERO ” Practice Location

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