MEDICARE: MICHELT ALEJANDRO WATER LOPEZ RBT

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-26-546676	FL

General Provider Information

NPI Number	:	1912823857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELT ALEJANDRO WATER LOPEZ RBT

Provider Business Mailing Address
First Line	:	4349 BUTTERSCOTCH CIR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-2768
Country	:	US
Telephone Number	:	863-709-3154
Fax Number	:

Provider Business Practice Location Address
First Line	:	4349 BUTTERSCOTCH CIR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-2768
Country	:	US
Telephone Number	:	863-709-3154
Fax Number	:

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

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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Directions to “ MICHELT ALEJANDRO WATER LOPEZ RBT” Practice Location

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