Provider Demographics
NPI:1790467835
Name:ALVAREZ, RODOLFO D (RBT-23-286530)
Entity Type:Individual
Prefix:
First Name:RODOLFO
Middle Name:D
Last Name:ALVAREZ
Suffix:
Gender:M
Credentials:RBT-23-286530
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17120 NW 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-4009
Mailing Address - Country:US
Mailing Address - Phone:786-201-1080
Mailing Address - Fax:
Practice Address - Street 1:17120 NW 52ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-4009
Practice Address - Country:US
Practice Address - Phone:786-201-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-286530106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician