Provider Demographics
NPI:1922718535
Name:DOMINGUEZ CALVO, CLAUDIA (RBT-22-237132)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:DOMINGUEZ CALVO
Suffix:
Gender:F
Credentials:RBT-22-237132
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 NW 79TH AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6530
Mailing Address - Country:US
Mailing Address - Phone:786-656-1819
Mailing Address - Fax:
Practice Address - Street 1:4260 NW 79TH AVE APT 2A
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6530
Practice Address - Country:US
Practice Address - Phone:786-656-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-237132106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician