MEDICARE: NABYLA PERTIERRA

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	RBT-23-267226	FL

General Provider Information

NPI Number	:	1053004168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NABYLA PERTIERRA

Provider Business Mailing Address
First Line	:	3515 NW 82ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-4539
Country	:	US
Telephone Number	:	786-508-3190
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 NW 82ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-4539
Country	:	US
Telephone Number	:	786-508-3180
Fax Number	:

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

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	03/05/2026

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Directions to “ NABYLA PERTIERRA ” Practice Location

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