MEDICARE: MARIA D BORREGO

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
2	106E00000X	Assistant Behavior Analyst	0-23-14957	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1639691140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA D BORREGO

Provider Business Mailing Address
First Line	:	850 SW 129TH PL APT 105
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-2102
Country	:	US
Telephone Number	:	786-470-6378
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 SW 129TH PL APT 105
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33184-2102
Country	:	US
Telephone Number	:	786-470-6378
Fax Number	:

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

Provider Enumeration Date	:	07/17/2017
Last Update Date	:	03/12/2026

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Directions to “ MARIA D BORREGO ” Practice Location

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