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General NPI Number Information
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NPI Number | 1114674132
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Entity Type | Individual
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Provider Name | SOFIA CRISTINA RENTE
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Gender | Female
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 198 WILSHIRE BLVD
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City | CASSELBERRY
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State | FL
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Zip | 32707-5352
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Country | US
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Telephone | 407-504-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 455 SHORT PINE CIR
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City | ORLANDO
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State | FL
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Zip | 32807-6265
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Country | US
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Telephone | 407-864-4069
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-185398
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-77217
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License Number State | FL
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