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NPI Code Detail

MEDICARE: MAGDA NORELYS PROENZA LMFT, BCBA

MEDICARE:   MAGDA NORELYS PROENZA  LMFT, 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
1106H00000XMarriage & Family TherapistMT 2848FL
2103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639271083
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGDA NORELYS PROENZA LMFT, BCBA
Provider Business Mailing Address
First Line : 18795 SW 160TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33187-1310
Country : US
Telephone Number : 305-815-6272
Fax Number :
Provider Business Practice Location Address
First Line : 18795 SW 160TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33187-1310
Country : US
Telephone Number : 305-815-6272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 04/17/2026

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