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General NPI Number Information
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NPI Number | 1063960151
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Entity Type | Individual
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Provider Name | MAIRELIZ GARCIA BRIZUELA
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Gender | Female
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Dates
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Enumeration Date | 09/17/2016
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 16275 SW 94TH ST
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City | MIAMI
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State | FL
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Zip | 33196-4920
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Country | US
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Telephone | 786-426-2294
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Fax |
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Provider Business Mailing Address
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Address Line | 3010 SW 102ND PL
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City | MIAMI
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State | FL
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Zip | 33165-2825
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Country | US
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Telephone | 786-426-2294
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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-19-80462
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License Number State | FL
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