Provider Demographics
NPI:1760244909
Name:DELGADO AVILA, ADRIAN ANTONIO (RBT-24-322713)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:ANTONIO
Last Name:DELGADO AVILA
Suffix:
Gender:M
Credentials:RBT-24-322713
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8920 NW 166TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6113
Mailing Address - Country:US
Mailing Address - Phone:786-262-9755
Mailing Address - Fax:
Practice Address - Street 1:8920 NW 166TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-6113
Practice Address - Country:US
Practice Address - Phone:786-262-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-322713106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician