Provider Demographics
NPI:1477168110
Name:ZAYAS GUILLEN, GERARDO A (RBT)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:A
Last Name:ZAYAS GUILLEN
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 1:60 E 3RD ST APT 1004
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4905
Mailing Address - Country:US
Mailing Address - Phone:786-867-9272
Mailing Address - Fax:
Practice Address - Street 1:60 E 3RD ST APT 1004
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4905
Practice Address - Country:US
Practice Address - Phone:786-867-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-130246106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician