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Annelly A Carreras

Behavior Technician

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Annelly A Carreras does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 2:35 PM.

Profile Details

Provider ID
1265103170
Provider Type
Individual
Full Name
Carreras, Annelly A
Credential
RBT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
9/22/2021
Last Updated
9/22/2021

Contact Information

Practice Location

5800 SW 109th Ave, Miami, FL 33173-1243

(305) 748-8662

Unlisted Fax

Mailing Location

5800 SW 109th Ave, Miami, FL 33173-1243

(305) 748-8662

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License 20-121088 Florida

Provider Identifiers

ID	Description	Issuer
ID 110308221033	Description Medicaid	Issuer Unlisted Florida

Annelly A Carreras

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Lopez, Maria Karla

Hernandez, Ivis

Puentes, Dayana

Velasco-Astete, Daniela Cristina

Garriga, Jacqueline

Montesino Piedad, Maria E

Grimany Rojo, Ana

Serret Hernandez, Dixan

Martinez Polo, Maylin

Serret, Teresa