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NPI Code Detail

MEDICARE: MIRELIS GONZALEZ GUERRA

MEDICARE: MIRELIS GONZALEZ GUERRA
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 TechnicianRBT-21-157158FL

General Provider Information

NPI Number : 1750162509
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRELIS GONZALEZ GUERRA
Provider Business Mailing Address
First Line : 539 NE 6TH TER
Second Line :
City : CAPE CORAL
State : FL
Zip : 33909-2008
Country : US
Telephone Number : 786-355-3896
Fax Number :
Provider Business Practice Location Address
First Line : 539 NE 6TH TER
Second Line :
City : CAPE CORAL
State : FL
Zip : 33909-2008
Country : US
Telephone Number : 786-355-3896
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2023
Last Update Date : 03/11/2026

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Directions to “ MIRELIS GONZALEZ GUERRA ” Practice Location

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