Healthcare Provider Details

I. General information

NPI: 1275166084
Provider Name (Legal Business Name): INGRID BUENO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 SW 27 AVE SUITE 207
MIAMI FL
33135
US

IV. Provider business mailing address

1250 SW 27 AVE SUITE 207
MIAMI FL
33135
US

V. Phone/Fax

Practice location:
  • Phone: 786-502-3137
  • Fax:
Mailing address:
  • Phone: 786-502-3137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: