Provider Demographics
NPI:1215549050
Name:EVERS, RYAN DANIEL (RBT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:DANIEL
Last Name:EVERS
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 1:11250 SW 61ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1024
Mailing Address - Country:US
Mailing Address - Phone:786-641-3813
Mailing Address - Fax:
Practice Address - Street 1:13155 SW 134TH ST STE 207
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4488
Practice Address - Country:US
Practice Address - Phone:786-842-3624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-119498106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician