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General NPI Number Information
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NPI Number | 1265303523
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Entity Type | Individual
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Provider Name | MAYLYN MATAMALA RIVERO
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Gender | Female
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 730 SAND LAKE RD STE 176
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City | ORLANDO
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State | FL
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Zip | 32809-7747
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Country | US
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Telephone | 407-412-6114
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Fax | 407-264-6097
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Provider Business Mailing Address
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Address Line | 5816 AUVER BLVD APT 8-206
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City | ORLANDO
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State | FL
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Zip | 32807-3760
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Country | US
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Telephone | 321-361-1601
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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-25-466083
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License Number State | FL
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