Provider Demographics
NPI:1114579240
Name:VICTORES, BARBARA ESTEFANI
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ESTEFANI
Last Name:VICTORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5460 NW 174TH DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3557
Mailing Address - Country:US
Mailing Address - Phone:305-901-9111
Mailing Address - Fax:
Practice Address - Street 1:5460 NW 174TH DR
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3557
Practice Address - Country:US
Practice Address - Phone:305-901-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-82813106S00000X
106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician