Provider Demographics
NPI:1609559459
Name:MARRERO SARMIENTO, NADIR (RBT-23-289416)
Entity Type:Individual
Prefix:
First Name:NADIR
Middle Name:
Last Name:MARRERO SARMIENTO
Suffix:
Gender:M
Credentials:RBT-23-289416
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 NE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-8812
Mailing Address - Country:US
Mailing Address - Phone:239-600-8170
Mailing Address - Fax:
Practice Address - Street 1:2817 NE 5TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-8812
Practice Address - Country:US
Practice Address - Phone:239-600-8170
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
FLRBT-23-289416106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician