Provider Demographics
NPI:1093455859
Name:SERANTES ZAYAS, RACHEL (RBT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SERANTES ZAYAS
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 1:1300 VIA LUGANO CIR APT 302
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-7195
Mailing Address - Country:US
Mailing Address - Phone:561-268-1488
Mailing Address - Fax:
Practice Address - Street 1:1300 VIA LUGANO CIR APT 302
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-7195
Practice Address - Country:US
Practice Address - Phone:561-268-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-23-14880106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109736000Medicaid