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General NPI Number Information
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NPI Number | 1578434619
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Entity Type | Individual
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Provider Name | EDGAR JOSE RUPERTI
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Gender | Male
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 1806 N FLAMINGO RD STE 110
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1027
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Country | US
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Telephone | 786-673-9355
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Fax | 954-342-6481
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Provider Business Mailing Address
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Address Line | 9801 SUNRISE LAKES BLVD APT 107
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City | SUNRISE
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State | FL
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Zip | 33322-6256
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Country | US
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Telephone | 786-613-1203
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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-25-465432
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License Number State | FL
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