Provider Demographics
NPI:1568216034
Name:TURRUELLA, BRANDON R
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:R
Last Name:TURRUELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9868 NW 126TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7407
Mailing Address - Country:US
Mailing Address - Phone:786-439-6673
Mailing Address - Fax:
Practice Address - Street 1:9868 NW 126TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-7407
Practice Address - Country:US
Practice Address - Phone:786-439-6673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-323689106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician