Provider Demographics
NPI:1851953541
Name:VALBUENA ARRIETA, BRYAN ANDRE (RBT)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:ANDRE
Last Name:VALBUENA ARRIETA
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 1:4553 SW 195TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6202
Mailing Address - Country:US
Mailing Address - Phone:786-719-0661
Mailing Address - Fax:
Practice Address - Street 1:4553 SW 195TH WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-6202
Practice Address - Country:US
Practice Address - Phone:786-719-0661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist