MEDICARE: MAYKEL BARRETO CERVERA

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-25-410458	FL

General Provider Information

NPI Number	:	1376338806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYKEL BARRETO CERVERA

Provider Business Mailing Address
First Line	:	5341 HAWKS LANDING DR APT 306
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-6663
Country	:	US
Telephone Number	:	239-309-4070
Fax Number	:

Provider Business Practice Location Address
First Line	:	5341 HAWKS LANDING DR APT 306
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-6663
Country	:	US
Telephone Number	:	239-309-4070
Fax Number	:

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

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	04/14/2025

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Directions to “ MAYKEL BARRETO CERVERA ” Practice Location

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