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NPI Code Detail

MEDICARE: LIZ MOURHEGE BA

MEDICARE:   LIZ  MOURHEGE  BA
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
1106S00000XBehavior TechnicianRBT-23-288713FL

General Provider Information

NPI Number : 1316785884
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIZ MOURHEGE BA
Provider Business Mailing Address
First Line : 5710 NW 3RD ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-4706
Country : US
Telephone Number : 786-556-9658
Fax Number :
Provider Business Practice Location Address
First Line : 5710 NW 3RD ST
Second Line :
City : MIAMI
State : FL
Zip : 33126-4706
Country : US
Telephone Number : 786-556-9658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2024
Last Update Date : 07/22/2024

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Directions to “ LIZ MOURHEGE BA” Practice Location

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