Provider Demographics
NPI:1083323562
Name:AMARAN RIVERO, DAVID (RBT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:AMARAN RIVERO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9442 NW 120TH ST APT 425
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4194
Mailing Address - Country:US
Mailing Address - Phone:305-764-2696
Mailing Address - Fax:
Practice Address - Street 1:9442 NW 120TH ST APT 425
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4194
Practice Address - Country:US
Practice Address - Phone:305-764-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician