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NPI Code Detail

MEDICARE: MAYERLI ALEJANDRA MANCIA BEHAVIOR TECHNICIAN

MEDICARE:   MAYERLI ALEJANDRA MANCIA  BEHAVIOR TECHNICIAN
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-21-180532FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1M520541028270OTHERFLDRIVER LICENSE

General Provider Information

NPI Number : 1407524481
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYERLI ALEJANDRA MANCIA BEHAVIOR TECHNICIAN
Provider Business Mailing Address
First Line : 1840 SW 42ND TER
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33317-6312
Country : US
Telephone Number : 954-493-3991
Fax Number :
Provider Business Practice Location Address
First Line : 1840 SW 42ND TER
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33317-6312
Country : US
Telephone Number : 954-493-3991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2021
Last Update Date : 09/02/2021

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Directions to “ MAYERLI ALEJANDRA MANCIA BEHAVIOR TECHNICIAN” Practice Location

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