Provider Demographics
NPI:1821878976
Name:IZAGUIRRE MILANES, OSCAR RAMON (RBT)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:RAMON
Last Name:IZAGUIRRE MILANES
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12736 SW 215TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5982
Mailing Address - Country:US
Mailing Address - Phone:786-484-5544
Mailing Address - Fax:
Practice Address - Street 1:12736 SW 215TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5982
Practice Address - Country:US
Practice Address - Phone:786-484-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-301337106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty