Provider Demographics
NPI:1821661026
Name:PINEIROS, MICAELA CAROLINA (RBT)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:CAROLINA
Last Name:PINEIROS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6816 SOUTHPOINT PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1700
Mailing Address - Country:US
Mailing Address - Phone:904-419-7792
Mailing Address - Fax:
Practice Address - Street 1:6816 SOUTHPOINT PKWY STE 2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1700
Practice Address - Country:US
Practice Address - Phone:904-419-7792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-21-171827106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician