Provider Demographics
NPI:1013597830
Name:SANCHEZ, NIEVES LINA (RBT)
Entity Type:Individual
Prefix:MS
First Name:NIEVES
Middle Name:LINA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 W 68TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4812
Mailing Address - Country:US
Mailing Address - Phone:305-930-1137
Mailing Address - Fax:
Practice Address - Street 1:639 W 68TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4812
Practice Address - Country:US
Practice Address - Phone:305-930-1137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109182100Medicaid