Healthcare Provider Details
I. General information
NPI: 1649938952
Provider Name (Legal Business Name): RUTH MARIA LORENZO BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/03/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11100 SW 184TH ST
CUTLER BAY FL
33157-6603
US
IV. Provider business mailing address
29250 SW 163RD CT
HOMESTEAD FL
33033-4117
US
V. Phone/Fax
- Phone: 305-720-0492
- Fax:
- Phone: 305-720-0492
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-26-90348 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | RBT-21-194190 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: