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General NPI Number Information
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NPI Number | 1407607583
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Entity Type | Individual
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Provider Name | NESLY ZELLERO MEDINA
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 103400 OVERSEAS HWY STE 240
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City | KEY LARGO
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State | FL
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Zip | 33037-2849
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Country | US
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Telephone | 305-998-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 14524 SW 280TH ST APT 108
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City | HOMESTEAD
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State | FL
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Zip | 33032-8399
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Country | US
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Telephone | 305-522-5440
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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-24-333514
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License Number State | FL
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