Provider Demographics
NPI:1417399148
Name:ALVAREZ, GABRIEL (RBT)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10664 LAGO WELLEBY DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8285
Mailing Address - Country:US
Mailing Address - Phone:954-826-4901
Mailing Address - Fax:
Practice Address - Street 1:1554 ORION LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-2327
Practice Address - Country:US
Practice Address - Phone:305-573-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-09929106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019745400Medicaid