MEDICARE: LUIS MANUEL MADRIGAL CAREAGA

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-25-503418	FL

General Provider Information

NPI Number	:	1790644375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS MANUEL MADRIGAL CAREAGA

Provider Business Mailing Address
First Line	:	1118 SW 9TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-3608
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	269 N UNIVERSITY DR STE E
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-6715
Country	:	US
Telephone Number	:	786-461-9978
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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