Provider Demographics
NPI:1205415619
Name:MENDOZA SILES, ARISBEL I (RBT)
Entity Type:Individual
Prefix:
First Name:ARISBEL
Middle Name:
Last Name:MENDOZA SILES
Suffix:I
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:ARISBEL
Other - Middle Name:
Other - Last Name:MENDOZA SILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:4711 W WATERS AVE APT 828
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1475
Mailing Address - Country:US
Mailing Address - Phone:813-817-7159
Mailing Address - Fax:
Practice Address - Street 1:3309 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2766
Practice Address - Country:US
Practice Address - Phone:813-898-0014
Practice Address - Fax:813-898-0015
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-03
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician