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NPI Code Detail

MEDICARE: MABIA VALDES LEBROC

MEDICARE: MABIA VALDES LEBROC
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 TechnicianFL
2106S00000XBehavior TechnicianRBT24399023FL

General Provider Information

NPI Number : 1568271195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MABIA VALDES LEBROC
Provider Business Mailing Address
First Line : 3110 5TH ST W
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33971-1441
Country : US
Telephone Number : 239-237-6405
Fax Number :
Provider Business Practice Location Address
First Line : 3351 MARINATOWN LN STE 200
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-7000
Country : US
Telephone Number : 239-895-5014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 01/07/2025

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Directions to “ MABIA VALDES LEBROC ” Practice Location

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