Provider Demographics
NPI:1710501630
Name:HERNANDEZ BEJERANO, KIRENIA (RBT-20-121557)
Entity Type:Individual
Prefix:
First Name:KIRENIA
Middle Name:
Last Name:HERNANDEZ BEJERANO
Suffix:
Gender:F
Credentials:RBT-20-121557
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17455 SW 112TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3911
Mailing Address - Country:US
Mailing Address - Phone:786-332-0416
Mailing Address - Fax:
Practice Address - Street 1:13500 SW 88TH ST STE 175
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1528
Practice Address - Country:US
Practice Address - Phone:305-387-0051
Practice Address - Fax:305-387-0053
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-121557106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician