Provider Demographics
NPI:1619509882
Name:RUBIO TORRES, ANNIA YAZMINA (BCABA)
Entity Type:Individual
Prefix:
First Name:ANNIA
Middle Name:YAZMINA
Last Name:RUBIO TORRES
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25664 SW 143RD PATH
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5305
Mailing Address - Country:US
Mailing Address - Phone:786-378-7777
Mailing Address - Fax:
Practice Address - Street 1:25664 SW 143RD PATH
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5305
Practice Address - Country:US
Practice Address - Phone:786-378-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FL0-24-15048106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty