Provider Demographics
NPI:1497538664
Name:ZAYAS FLEITAS, SUSANA (RBT)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:ZAYAS FLEITAS
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 1:6851 BRIDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3565
Mailing Address - Country:US
Mailing Address - Phone:561-563-1421
Mailing Address - Fax:
Practice Address - Street 1:1300 NW 17TH AVE STE 272
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2562
Practice Address - Country:US
Practice Address - Phone:786-488-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-273744106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician