Provider Demographics
NPI:1801764402
Name:COLMENARES VELIZ, ANUBIS
Entity type:Individual
Prefix:
First Name:ANUBIS
Middle Name:
Last Name:COLMENARES VELIZ
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 1:8748 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3939
Mailing Address - Country:US
Mailing Address - Phone:786-922-8446
Mailing Address - Fax:
Practice Address - Street 1:1400 NW 107TH AVE STE 306
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2746
Practice Address - Country:US
Practice Address - Phone:305-502-6282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-485544106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician