MEDICARE: DANIELA MERCEDES ENRIQUEZ BCBA

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	1-25-81594	FL

General Provider Information

NPI Number	:	1558254912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELA MERCEDES ENRIQUEZ BCBA

Provider Business Mailing Address
First Line	:	1781 NW 16TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-2305
Country	:	US
Telephone Number	:	305-216-3806
Fax Number	:

Provider Business Practice Location Address
First Line	:	9425 SW 72ND ST STE 164
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-3290
Country	:	US
Telephone Number	:	305-279-2286
Fax Number	:

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

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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