Provider Demographics
NPI:1609461318
Name:ALICEA, HECTOR (RBT)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:
Last Name:ALICEA
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 1:1406 SW TRAFALGAR PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-3289
Mailing Address - Country:US
Mailing Address - Phone:203-343-1868
Mailing Address - Fax:
Practice Address - Street 1:114 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1724
Practice Address - Country:US
Practice Address - Phone:239-888-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTRBT-20-110106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician