MEDICARE: SHELOOSE SALOMON RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1023854882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELOOSE SALOMON RBT

Provider Business Mailing Address
First Line	:	8130 ROYAL PALM BLVD STE 105
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8130 ROYAL PALM BLVD STE 105
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5703
Country	:	US
Telephone Number	:	954-344-6550
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	04/16/2026

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Directions to “ SHELOOSE SALOMON RBT” Practice Location

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