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General NPI Number Information
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NPI Number | 1831978691
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Entity Type | Individual
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Provider Name | JEANINE BEATRIZ MALTEZ
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Gender | Female
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 7800 S RED RD STE 205
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5542
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Country | US
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Telephone | 305-854-2471
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Fax |
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Provider Business Mailing Address
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Address Line | 13211 SW 6TH ST
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City | MIAMI
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State | FL
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Zip | 33184-1145
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Country | US
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Telephone | 786-391-5323
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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-23-298437
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License Number State | CO
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