Healthcare Provider Details

I. General information

NPI: 1689569006
Provider Name (Legal Business Name): LUIS BEBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11890 SW 8TH ST STE 309
MIAMI FL
33184-1710
US

IV. Provider business mailing address

11541 NW 2ND ST APT 106
MIAMI FL
33172-4951
US

V. Phone/Fax

Practice location:
  • Phone: 305-220-6060
  • Fax:
Mailing address:
  • Phone: 786-653-6341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-414900
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: