Provider Demographics
NPI:1497492557
Name:FERNANDEZ MONTERO, LISBET
Entity Type:Individual
Prefix:
First Name:LISBET
Middle Name:
Last Name:FERNANDEZ MONTERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 NW 7TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2266
Mailing Address - Country:US
Mailing Address - Phone:786-241-3527
Mailing Address - Fax:
Practice Address - Street 1:4705 NW 7TH ST APT 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2266
Practice Address - Country:US
Practice Address - Phone:786-241-3527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-206355106S00000X
FL1-23-63729103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician