Provider Demographics
NPI:1972139715
Name:MARIMON CONCEPCION, NEREYDA (RBT)
Entity Type:Individual
Prefix:
First Name:NEREYDA
Middle Name:
Last Name:MARIMON CONCEPCION
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 1:2821 N MIAMI BEACH BLVD
Mailing Address - Street 2:APT 2 O
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160
Mailing Address - Country:US
Mailing Address - Phone:786-333-7840
Mailing Address - Fax:
Practice Address - Street 1:2821 N MIAMI BEACH BLVD
Practice Address - Street 2:APT 2 O
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:786-333-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-12
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-113589106S00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician