Provider Demographics
NPI:1326710153
Name:RUANO SANCHEZ, VIVIAN ODALIS (RBT)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:ODALIS
Last Name:RUANO SANCHEZ
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 1:3740 SW 89TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-4341
Mailing Address - Country:US
Mailing Address - Phone:786-443-5034
Mailing Address - Fax:
Practice Address - Street 1:3740 SW 89TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-4341
Practice Address - Country:US
Practice Address - Phone:786-443-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-97257106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician