MEDICARE: DAVID BRIZUELA

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	103K00000X	Behavior Analyst	1-22-62286	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942827548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BRIZUELA

Provider Business Mailing Address
First Line	:	6009 SW 114TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-1090
Country	:	US
Telephone Number	:	786-942-8066
Fax Number	:

Provider Business Practice Location Address
First Line	:	6009 SW 114TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-1090
Country	:	US
Telephone Number	:	786-942-8066
Fax Number	:

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

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	01/16/2026

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Directions to “ DAVID BRIZUELA ” Practice Location

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