Provider Demographics
NPI:1851917223
Name:JAIMES ZAMBRANO, VICTORIA JOSE (RBT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JOSE
Last Name:JAIMES ZAMBRANO
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 1:5430 BUCHANAN RD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-4218
Mailing Address - Country:US
Mailing Address - Phone:786-630-9411
Mailing Address - Fax:
Practice Address - Street 1:5430 BUCHANAN RD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-4218
Practice Address - Country:US
Practice Address - Phone:786-630-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-20-128920106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107575200Medicaid