MEDICARE: MRS. SAMANTHA NICHOLE ARRIOJA RBT

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	104100000X	Social Worker		FL
2	106S00000X	Behavior Technician	RBT-18-63271	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RBT-18-63271	OTHER	FL	BACB

General Provider Information

NPI Number	:	1336602127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAMANTHA NICHOLE ARRIOJA RBT

Provider Business Mailing Address
First Line	:	5050 9TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32966-2838
Country	:	US
Telephone Number	:	305-393-0179
Fax Number	:

Provider Business Practice Location Address
First Line	:	5050 9TH ST
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32966-2838
Country	:	US
Telephone Number	:	305-393-0179
Fax Number	:

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

Provider Enumeration Date	:	04/09/2019
Last Update Date	:	06/10/2019

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