Provider Demographics
NPI:1609559335
Name:CABRERA BISONO, KIAMALY STEIPHY (RBT,BCBA)
Entity Type:Individual
Prefix:DR
First Name:KIAMALY
Middle Name:STEIPHY
Last Name:CABRERA BISONO
Suffix:
Gender:F
Credentials:RBT,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 BETSY ROSS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-7099
Mailing Address - Country:US
Mailing Address - Phone:917-940-4786
Mailing Address - Fax:
Practice Address - Street 1:7594 W SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5188
Practice Address - Country:US
Practice Address - Phone:800-875-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3097103TC2200X
FLRBT-17-42600106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent