MEDICARE: MAYKA CUEVAS LOPEZ

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	RBT26507988	FL

General Provider Information

NPI Number	:	1114886017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYKA CUEVAS LOPEZ

Provider Business Mailing Address
First Line	:	2823 STONEWAY LN APT B
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-4342
Country	:	US
Telephone Number	:	786-332-1109
Fax Number	:

Provider Business Practice Location Address
First Line	:	2823 STONEWAY LN APT B
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-4342
Country	:	US
Telephone Number	:	786-332-1109
Fax Number	:

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

Provider Enumeration Date	:	01/17/2026
Last Update Date	:	01/17/2026

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