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NPI 1679394803

NPI 1679394803 : EIMY RUBY BENITEZ RBT : MIAMI LAKES, FL

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General NPI Number Information
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    NPI Number           |    1679394803
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    Entity Type          |    Individual 
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    Provider Name        |    EIMY RUBY BENITEZ RBT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/21/2024
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    Last Update Date     |    10/21/2024
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Provider Practice Location Address
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    Address Line         |    5767 NW 151ST ST # B 
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    City                 |    MIAMI LAKES
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    State                |    FL
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    Zip                  |    33014-2483
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    Country              |    US
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    Telephone            |    786-431-5801
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    Fax                  |    786-882-3232
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Provider Business Mailing Address
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    Address Line         |    10419 NW 36TH CT 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33147-1033
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    Country              |    US
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    Telephone            |    754-251-9563
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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-24-386167
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    License Number State |    FL
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