Provider Demographics
NPI:1568791796
Name:LINARES, SUSANA M (BCABA)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:M
Last Name:LINARES
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 WESTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3638
Mailing Address - Country:US
Mailing Address - Phone:954-589-1038
Mailing Address - Fax:866-883-9515
Practice Address - Street 1:2800 WESTON RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3638
Practice Address - Country:US
Practice Address - Phone:954-589-1038
Practice Address - Fax:866-883-9515
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-03-1023103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst