Provider Demographics
NPI:1083324115
Name:RUBIO CONEJO, AINADI D (RBT)
Entity Type:Individual
Prefix:
First Name:AINADI
Middle Name:D
Last Name:RUBIO CONEJO
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 1:11135 NW 59TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6510
Mailing Address - Country:US
Mailing Address - Phone:786-488-3688
Mailing Address - Fax:
Practice Address - Street 1:11135 NW 59TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6510
Practice Address - Country:US
Practice Address - Phone:786-488-3688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-106677106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician