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General NPI Number Information
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NPI Number | 1003637182
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Entity Type | Individual
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Provider Name | MARIA V PUCHE MENDEZ
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 4801 S UNIVERSITY DR STE 130
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City | DAVIE
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State | FL
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Zip | 33328-3832
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Country | US
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Telephone | 954-592-8659
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Fax | 561-516-8183
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Provider Business Mailing Address
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Address Line | 14072 SW 32ND ST
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City | MIRAMAR
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State | FL
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Zip | 33027-3979
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Country | US
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Telephone | 305-767-8949
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-371199
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License Number State | FL
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