MEDICARE: MILENA LLORENTE DEUS

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	RBT-20-125183	FL

General Provider Information

NPI Number	:	1780281428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILENA LLORENTE DEUS

Provider Business Mailing Address
First Line	:	1650 W 56TH ST APT 312
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2057
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 W 56TH ST APT 312
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2057
Country	:	US
Telephone Number	:	786-690-2154
Fax Number	:

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

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	10/06/2020

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Directions to “ MILENA LLORENTE DEUS ” Practice Location

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