MEDICARE: MELISSA D SUAREZ CHAVEZ

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-23-299488	FL

General Provider Information

NPI Number	:	1811761539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA D SUAREZ CHAVEZ

Provider Business Mailing Address
First Line	:	12249 SW 18TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-7365
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12249 SW 18TH TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-7365
Country	:	US
Telephone Number	:	786-832-4494
Fax Number	:

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

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	11/13/2023

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Directions to “ MELISSA D SUAREZ CHAVEZ ” Practice Location

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