Provider Demographics
NPI:1346775012
Name:LIRIANO SANTOS, KIRSIS MERCEDES (RBT)
Entity Type:Individual
Prefix:
First Name:KIRSIS
Middle Name:MERCEDES
Last Name:LIRIANO SANTOS
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 1:14734 ROYAL POINCIANA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7329
Mailing Address - Country:US
Mailing Address - Phone:407-401-2751
Mailing Address - Fax:
Practice Address - Street 1:14734 ROYAL POINCIANA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7329
Practice Address - Country:US
Practice Address - Phone:407-401-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-17-30969106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician