MEDICARE: MELISA QUELLE ALVAREZ RBT

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-25-415795	FL

General Provider Information

NPI Number	:	1871397547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISA QUELLE ALVAREZ RBT

Provider Business Mailing Address
First Line	:	12311 SW 214TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-5958
Country	:	US
Telephone Number	:	305-632-8410
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 FAIRWAY DR
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1812
Country	:	US
Telephone Number	:	786-640-1404
Fax Number	:

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

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	03/05/2026

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