Healthcare Provider Details

I. General information

NPI: 1720603921
Provider Name (Legal Business Name): MARITZA HERNANDEZ CASEIRO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11119 W OKEECHOBEE RD UNIT 125
HIALEAH GARDENS FL
33018-4233
US

IV. Provider business mailing address

11119 W OKEECHOBEE RD UNIT 125
HIALEAH GARDENS FL
33018-4233
US

V. Phone/Fax

Practice location:
  • Phone: 305-998-8532
  • Fax:
Mailing address:
  • Phone: 305-998-8532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-120848
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: