MEDICARE: JENEBITH K FUENMAYOR VILLALOBOS

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	25470326	FL

General Provider Information

NPI Number	:	1588535272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENEBITH K FUENMAYOR VILLALOBOS

Provider Business Mailing Address
First Line	:	922 SHELDON AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-3338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	922 SHELDON AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-3338
Country	:	US
Telephone Number	:	786-492-9323
Fax Number	:

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	03/25/2026

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Directions to “ JENEBITH K FUENMAYOR VILLALOBOS ” Practice Location

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