MEDICARE: ODALYS QUIROZ

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	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician
3	106S00000X	Behavior Technician	20-145959	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376074906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ODALYS QUIROZ

Provider Business Mailing Address
First Line	:	1040 SW 24TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33135-4820
Country	:	US
Telephone Number	:	786-487-4547
Fax Number	:

Provider Business Practice Location Address
First Line	:	3930 NW 7TH ST APT 302
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-5561
Country	:	US
Telephone Number	:	786-487-4547
Fax Number	:

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

Provider Enumeration Date	:	03/24/2017
Last Update Date	:	03/30/2026

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Directions to “ ODALYS QUIROZ ” Practice Location

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