Provider Demographics
NPI:1295217214
Name:HECHAVARRIA, LAZARA F (RBT)
Entity Type:Individual
Prefix:MRS
First Name:LAZARA
Middle Name:F
Last Name:HECHAVARRIA
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 1:14134 SW 77TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-3074
Mailing Address - Country:US
Mailing Address - Phone:786-521-7471
Mailing Address - Fax:786-703-8190
Practice Address - Street 1:14134 SW 77TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3074
Practice Address - Country:US
Practice Address - Phone:786-521-7471
Practice Address - Fax:786-703-8190
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021963800Medicaid