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NPI Code Detail

MEDICARE: REBEKAH BLANCA MARQUEZ

MEDICARE: REBEKAH BLANCA MARQUEZ
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 Technician
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 : 1770040339
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH BLANCA MARQUEZ
Provider Business Mailing Address
First Line : 2945 PEMBRIDGE ST
Second Line :
City : KISSIMMEE
State : FL
Zip : 34747-1628
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7600 DR PHILLIPS BLVD STE 72
Second Line :
City : ORLANDO
State : FL
Zip : 32819-7238
Country : US
Telephone Number : 407-730-5969
Fax Number : 407-506-0762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2019
Last Update Date : 01/10/2022

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