Provider Demographics
NPI:1467204081
Name:BRITO, LIBIA ESTHER (BCABA 0-24-15171)
Entity Type:Individual
Prefix:
First Name:LIBIA
Middle Name:ESTHER
Last Name:BRITO
Suffix:
Gender:F
Credentials:BCABA 0-24-15171
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13515 NE 24TH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3522
Mailing Address - Country:US
Mailing Address - Phone:305-790-6717
Mailing Address - Fax:
Practice Address - Street 1:13515 NE 24TH PL
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3522
Practice Address - Country:US
Practice Address - Phone:305-790-6717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-24-15171106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst