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General NPI Number Information
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NPI Number | 1417479924
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Entity Type | Individual
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Provider Name | NILET RUIZ ASENCIO
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Gender | Female
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15422 SW 284TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-1459
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Country | US
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Telephone | 786-369-9666
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 SE 24TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33035-2457
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Country | US
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Telephone | 786-369-9666
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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 |
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License Number State |
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