Provider Demographics
NPI:1578682563
Name:MARINAS, ROSSNIEL (DPT - BCBA)
Entity Type:Individual
Prefix:
First Name:ROSSNIEL
Middle Name:
Last Name:MARINAS
Suffix:
Gender:M
Credentials:DPT - BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 W 27TH CT APT 22
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4317
Mailing Address - Country:US
Mailing Address - Phone:305-979-1776
Mailing Address - Fax:
Practice Address - Street 1:6460 W 27TH CT APT 22
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4317
Practice Address - Country:US
Practice Address - Phone:305-979-1776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 21736225100000X
FLBCBA1-23-65381103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist