MEDICARE: WENDOLYN LOPEZ RIVERA

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	RBT25487114	FL

General Provider Information

NPI Number	:	1235008939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDOLYN LOPEZ RIVERA

Provider Business Mailing Address
First Line	:	10481 SW 216TH ST APT 210
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1644
Country	:	US
Telephone Number	:	786-247-4774
Fax Number	:

Provider Business Practice Location Address
First Line	:	10481 SW 216TH ST APT 210
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1644
Country	:	US
Telephone Number	:	786-247-4774
Fax Number	:

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

Provider Enumeration Date	:	10/31/2025
Last Update Date	:	10/31/2025

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Directions to “ WENDOLYN LOPEZ RIVERA ” Practice Location

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