Healthcare Provider Details

I. General information

NPI: 1124678958
Provider Name (Legal Business Name): IVONNE TORRES CHAVIANO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2019
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 E 52ND ST
HIALEAH FL
33013-1426
US

IV. Provider business mailing address

241 E 52ND ST
HIALEAH FL
33013-1426
US

V. Phone/Fax

Practice location:
  • Phone: 786-537-9791
  • Fax:
Mailing address:
  • Phone: 786-537-9791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS69989
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: