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General NPI Number Information
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NPI Number | 1821634031
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Entity Type | Individual
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Provider Name | ROBERTO A DOMINGUEZ SUAREZ BCBA
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Gender | Male
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 2152 SW 72ND AVE
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City | MIAMI
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State | FL
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Zip | 33155-1433
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Country | US
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Telephone | 786-975-3716
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Fax |
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Provider Business Mailing Address
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Address Line | 2152 SW 72ND AVE
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City | MIAMI
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State | FL
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Zip | 33155-1433
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Country | US
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Telephone | 786-975-3716
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-21-11839
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-98644
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-59612
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License Number State | FL
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