MEDICARE: ARIAMNET ALEMAN RODRIGUEZ

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-24-349988	FL

General Provider Information

NPI Number	:	1780416305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIAMNET ALEMAN RODRIGUEZ

Provider Business Mailing Address
First Line	:	6906 NW HERSHY CIR
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-1319
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6906 NW HERSHY CIR
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34983-1319
Country	:	US
Telephone Number	:	772-577-9362
Fax Number	:

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

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	08/14/2024

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