MEDICARE: MAIRELIS GIZ

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-21-156572	FL

General Provider Information

NPI Number	:	1497524789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAIRELIS GIZ

Provider Business Mailing Address
First Line	:	4400 PGA BLVD STE 600
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6556
Country	:	US
Telephone Number	:	561-812-8666
Fax Number	:

Provider Business Practice Location Address
First Line	:	5211 GINGER WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-4440
Country	:	US
Telephone Number	:	702-945-7684
Fax Number	:

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

Provider Enumeration Date	:	12/27/2023
Last Update Date	:	12/27/2023

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Directions to “ MAIRELIS GIZ ” Practice Location

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