MEDICARE: KAITLYN MARIE IUSPA

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-26-539869	FL

General Provider Information

NPI Number	:	1063346740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN MARIE IUSPA

Provider Business Mailing Address
First Line	:	4000 SW 149TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4166
Country	:	US
Telephone Number	:	305-606-8858
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 SW 149TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185-4166
Country	:	US
Telephone Number	:	305-606-8858
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ KAITLYN MARIE IUSPA ” Practice Location

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