Provider Demographics
NPI:1043757198
Name:POMARES, ARLETTE (RBT)
Entity Type:Individual
Prefix:
First Name:ARLETTE
Middle Name:
Last Name:POMARES
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 1:8830 W 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1867
Mailing Address - Country:US
Mailing Address - Phone:786-223-4591
Mailing Address - Fax:
Practice Address - Street 1:8830 W 33RD AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018
Practice Address - Country:US
Practice Address - Phone:786-223-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-27
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-18-62192106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019864000Medicaid
RBT-18-62192OtherBEHAVIOR ANALYST CERTIFICATION BOARD