Provider Demographics
NPI:1871231530
Name:BRICENO, MARIA EUGENIA I (RBTS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:EUGENIA
Last Name:BRICENO
Suffix:I
Gender:F
Credentials:RBTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 LAKE HOWELL RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5922
Mailing Address - Country:US
Mailing Address - Phone:407-394-3689
Mailing Address - Fax:
Practice Address - Street 1:8926 TIBERIAN DR APT 202
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-1164
Practice Address - Country:US
Practice Address - Phone:407-394-3689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-207316106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician