Provider Demographics
NPI:1477146322
Name:PUIGBO, MONICA (RBT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:PUIGBO
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 1:11320 SW 61ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1064
Mailing Address - Country:US
Mailing Address - Phone:305-927-9980
Mailing Address - Fax:
Practice Address - Street 1:11320 SW 61ST TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1064
Practice Address - Country:US
Practice Address - Phone:305-927-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-152987106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician