Provider Demographics
NPI:1659062677
Name:RICARDO ABELLON, DORYS BARBARA
Entity Type:Individual
Prefix:
First Name:DORYS
Middle Name:BARBARA
Last Name:RICARDO ABELLON
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 1:3270 NW 208TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-1359
Mailing Address - Country:US
Mailing Address - Phone:786-806-3401
Mailing Address - Fax:
Practice Address - Street 1:3270 NW 208TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-1359
Practice Address - Country:US
Practice Address - Phone:786-806-3401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-266470106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician