MEDICARE: LARITZA DE JESUS ESPINOSA MARINO

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	RBT-25-485985	FL

General Provider Information

NPI Number	:	1366311961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARITZA DE JESUS ESPINOSA MARINO

Provider Business Mailing Address
First Line	:	5081 MINA CIR APT 404
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-7848
Country	:	US
Telephone Number	:	786-794-8649
Fax Number	:

Provider Business Practice Location Address
First Line	:	5081 MINA CIR APT 404
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-7848
Country	:	US
Telephone Number	:	786-794-8649
Fax Number	:

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

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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Directions to “ LARITZA DE JESUS ESPINOSA MARINO ” Practice Location

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