Provider Demographics
NPI:1417318031
Name:RUBIO FERNANDEZ, LIZBET (BCBA)
Entity Type:Individual
Prefix:
First Name:LIZBET
Middle Name:
Last Name:RUBIO FERNANDEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5077 NW 7TH ST APT 1202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3465
Mailing Address - Country:US
Mailing Address - Phone:786-344-5720
Mailing Address - Fax:
Practice Address - Street 1:5077 NW 7TH ST APT 1202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3465
Practice Address - Country:US
Practice Address - Phone:786-344-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0146369103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst