MEDICARE: HENRY ENRIQUEZ

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	BACB1018083	FL

General Provider Information

NPI Number	:	1922874395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY ENRIQUEZ

Provider Business Mailing Address
First Line	:	8545 HARDING AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-1207
Country	:	US
Telephone Number	:	305-975-7375
Fax Number	:

Provider Business Practice Location Address
First Line	:	8545 HARDING AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-1207
Country	:	US
Telephone Number	:	305-975-7375
Fax Number	:

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

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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Directions to “ HENRY ENRIQUEZ ” Practice Location

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