MEDICARE: NICHOLE EMELY MARK

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
2	103K00000X	Behavior Analyst	1-24-75202	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	:	1982323986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE EMELY MARK

Provider Business Mailing Address
First Line	:	19023 NW 78TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5275
Country	:	US
Telephone Number	:	305-905-1254
Fax Number	:

Provider Business Practice Location Address
First Line	:	19023 NW 78TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5275
Country	:	US
Telephone Number	:	305-905-1254
Fax Number	:

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

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	05/05/2026

Similar Medicare Providers

1265228894 — MRS. MELINDA DIAZ MARTINEZ RBT
Practice Location Address:

7202 W 4TH AVE # 2-101
HIALEAH, FL
33014-5275

Practice Phone: 786-274-3330
Practice Fax:

1548090418 — KEVIN OSVALDO JARQUIN
Practice Location Address:

5911 NW 173RD DR UNIT 11
HIALEAH, FL
33015-5122

Practice Phone: 786-655-9992
Practice Fax:

1508217472 — YANET DE LAS MERCEDES GONZALEZ
Practice Location Address:

8010 NW 172ND ST
HIALEAH, FL
33015-3853

Practice Phone: 786-312-2105
Practice Fax:

1962339564 — CINDY RODRIGUEZ
Practice Location Address:

5930 NW 186TH ST APT 201
HIALEAH, FL
33015-8034

Practice Phone: 786-943-2498
Practice Fax:

1275460644 — BARBARA RACHEL RICABAL
Practice Location Address:

17950 NW 78TH CT
HIALEAH, FL
33015-2811

Practice Phone: 786-774-2233
Practice Fax:

1922936244 — VIDA SAUDE TELEHEALTH LLC
Practice Location Address:

17840 NW 59TH AVE UNIT 101
HIALEAH, FL
33015-5161

Practice Phone: 786-552-2921
Practice Fax:

Directions to “ NICHOLE EMELY MARK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.