Healthcare Provider Details

I. General information

NPI: 1487461471
Provider Name (Legal Business Name): MELISSA EXPOSITO ROMERO RBT (106S00000X)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 NORTHBROOKE PLAZA DR
NAPLES FL
34119-8099
US

IV. Provider business mailing address

2575 NORTHBROOKE PLAZA DR
NAPLES FL
34119-8099
US

V. Phone/Fax

Practice location:
  • Phone: 239-465-3546
  • Fax: 239-325-9478
Mailing address:
  • Phone: 239-465-3546
  • Fax: 239-325-9478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number24-389415
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: