MEDICARE: ANAMARY HERNANDEZ VELIZ

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

General Provider Information

NPI Number	:	1407676349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAMARY HERNANDEZ VELIZ

Provider Business Mailing Address
First Line	:	4645 SE 11TH PL STE 304
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-9219
Country	:	US
Telephone Number	:	239-201-8304
Fax Number	:

Provider Business Practice Location Address
First Line	:	4645 SE 11TH PL STE 304
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-9219
Country	:	US
Telephone Number	:	239-201-8304
Fax Number	:

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

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	10/15/2024

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Directions to “ ANAMARY HERNANDEZ VELIZ ” Practice Location

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