Provider Demographics
NPI:1598453839
Name:SANTANA CESPEDES, RAYDEL WILLIAM (RBT)
Entity Type:Individual
Prefix:
First Name:RAYDEL
Middle Name:WILLIAM
Last Name:SANTANA CESPEDES
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 1:11161 SW 241ST ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5127
Mailing Address - Country:US
Mailing Address - Phone:305-216-8402
Mailing Address - Fax:
Practice Address - Street 1:11161 SW 241ST ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5127
Practice Address - Country:US
Practice Address - Phone:305-216-8402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-263751106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician