Provider Demographics
NPI:1629717053
Name:OVIEDO, ALINA PAULA (RBT)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:PAULA
Last Name:OVIEDO
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 1:1569 CRANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-1835
Mailing Address - Country:US
Mailing Address - Phone:239-200-9509
Mailing Address - Fax:
Practice Address - Street 1:8270 BURNT STORE RD UNIT 3
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-4705
Practice Address - Country:US
Practice Address - Phone:941-456-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-2161166106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician