Healthcare Provider Details

I. General information

NPI: 1811805401
Provider Name (Legal Business Name): RACHEL BEDOYA ATIENZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 E 8TH ST
HIALEAH FL
33010-4539
US

IV. Provider business mailing address

491 E 8TH ST
HIALEAH FL
33010-4539
US

V. Phone/Fax

Practice location:
  • Phone: 305-462-4498
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-479140
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: