Provider Demographics
NPI:1356006217
Name:MERITIL, VANESSA LIZBETH (RBT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:LIZBETH
Last Name:MERITIL
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 1:12100 STERLING UNIVERSITY LN UNIT 2213
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-2411
Mailing Address - Country:US
Mailing Address - Phone:407-486-8416
Mailing Address - Fax:
Practice Address - Street 1:217 E OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4503
Practice Address - Country:US
Practice Address - Phone:407-368-9971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-176856106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician