Provider Demographics
NPI:1750853859
Name:OCAMPO ANDINA, BEATRIZ
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:
Last Name:OCAMPO ANDINA
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 1:11119 W OKEECHOBEE RD UNIT 144
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4234
Mailing Address - Country:US
Mailing Address - Phone:305-244-1769
Mailing Address - Fax:
Practice Address - Street 1:11119 W OKEECHOBEE RD UNIT 144
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-4234
Practice Address - Country:US
Practice Address - Phone:305-244-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-30
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-73659106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician