Provider Demographics
NPI:1629627567
Name:PINERA BARRENECHE, DULCE (RBT)
Entity Type:Individual
Prefix:
First Name:DULCE
Middle Name:
Last Name:PINERA BARRENECHE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 SW 153 CT APT #205
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1731
Mailing Address - Country:US
Mailing Address - Phone:786-663-0635
Mailing Address - Fax:
Practice Address - Street 1:6625 MIAMI LAKES DR. SUITE 344
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2738
Practice Address - Country:US
Practice Address - Phone:305-777-3883
Practice Address - Fax:305-777-3837
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-78008106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103644200Medicaid