Provider Demographics
NPI:1639669492
Name:REYES IMBERT, BELKIS
Entity Type:Individual
Prefix:
First Name:BELKIS
Middle Name:
Last Name:REYES IMBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16900 N BAY RD APT 1201
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4268
Mailing Address - Country:US
Mailing Address - Phone:786-678-9255
Mailing Address - Fax:
Practice Address - Street 1:16900 N BAY RD APT 1201
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4268
Practice Address - Country:US
Practice Address - Phone:786-678-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CO0-21-12413103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician