Healthcare Provider Details

I. General information

NPI: 1699252494
Provider Name (Legal Business Name): REGLA ADNALOY SERUTI ZEQUEIRA RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15532 SW 127TH AVE APT 107
MIAMI FL
33177-1448
US

IV. Provider business mailing address

15532 SW 127TH AVE APT 107
MIAMI FL
33177-1448
US

V. Phone/Fax

Practice location:
  • Phone: 786-768-6397
  • Fax:
Mailing address:
  • Phone: 786-768-6397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number020731200
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: