Provider Demographics
NPI:1851749246
Name:MOSQUERA, VISLOVIA (RBT)
Entity Type:Individual
Prefix:
First Name:VISLOVIA
Middle Name:
Last Name:MOSQUERA
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 1:29845 SW 144TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-3910
Mailing Address - Country:US
Mailing Address - Phone:305-772-2755
Mailing Address - Fax:
Practice Address - Street 1:29845 SW 144TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033
Practice Address - Country:US
Practice Address - Phone:305-772-2755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018764300Medicaid