Mauro Jorge Roque Hernandez

NPI #1841700325 in Lehigh Acres, Florida

Provider Information

NPI Number: 1841700325
Entity Type: Individual
Name: Mauro Jorge Roque Hernandez
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Oct 10, 2017
Last Updated: Oct 10, 2017

Practice Location

Address: 1412 JUDDALE ST E
City: Lehigh Acres
State: Florida
ZIP Code: 33936-5812
Phone: (239) 244-7727

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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