MEDICARE: LUIS BRETONES SR. SLPA

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	2355S0801X	Speech-Language Assistant	SI 1202	FL
2	103K00000X	Behavior Analyst	1-21-56731	FL

General Provider Information

NPI Number	:	1164504643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS BRETONES SR. SLPA

Provider Business Mailing Address
First Line	:	145 WATERWAY RD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1554
Country	:	US
Telephone Number	:	305-767-9101
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 WATERWAY RD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1554
Country	:	US
Telephone Number	:	305-767-9101
Fax Number	:

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	01/16/2026

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Directions to “ LUIS BRETONES SR. SLPA” Practice Location

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