MEDICARE: KENIA BRITO

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

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	:	1992349161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENIA BRITO

Provider Business Mailing Address
First Line	:	491 E 17TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3250
Country	:	US
Telephone Number	:	786-343-6531
Fax Number	:

Provider Business Practice Location Address
First Line	:	491 E 17TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3250
Country	:	US
Telephone Number	:	786-343-6531
Fax Number	:

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

Provider Enumeration Date	:	10/31/2019
Last Update Date	:	10/31/2019

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Directions to “ KENIA BRITO ” Practice Location

Language	Start Address	Practice Location

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