Provider Demographics
NPI:1891400024
Name:BERNARD, ROULDY ALAND (RBT)
Entity Type:Individual
Prefix:
First Name:ROULDY
Middle Name:ALAND
Last Name:BERNARD
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 1:7833 CORAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5864
Mailing Address - Country:US
Mailing Address - Phone:786-832-1857
Mailing Address - Fax:
Practice Address - Street 1:7833 CORAL BLVD
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5864
Practice Address - Country:US
Practice Address - Phone:786-832-1857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-253592106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-23-253592OtherRBT CERTIFICATION