Provider Demographics
NPI:1467153841
Name:PENA ALVAREZ BUYLLA, XIOMARA (RBT, BS)
Entity Type:Individual
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First Name:XIOMARA
Middle Name:
Last Name:PENA ALVAREZ BUYLLA
Suffix:
Gender:F
Credentials:RBT, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:5727 NW 7TH ST STE 218
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3105
Mailing Address - Country:US
Mailing Address - Phone:305-264-3939
Mailing Address - Fax:
Practice Address - Street 1:14221 SW 120TH ST STE 214
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4224
Practice Address - Country:US
Practice Address - Phone:786-452-1185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician