Provider Demographics
NPI:1598532905
Name:ALBERT, BRYAN CESAR
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:CESAR
Last Name:ALBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 NW 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4925
Mailing Address - Country:US
Mailing Address - Phone:305-481-4755
Mailing Address - Fax:561-516-8183
Practice Address - Street 1:4801 S UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 130
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328
Practice Address - Country:US
Practice Address - Phone:954-592-8659
Practice Address - Fax:561-516-8183
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-303199106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician