Provider Demographics
NPI:1013687912
Name:BATLLE, VERONICA ALEXANDRIA
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:ALEXANDRIA
Last Name:BATLLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 S ROYAL POINCIANA BLVD APT 205
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-7237
Mailing Address - Country:US
Mailing Address - Phone:305-495-4632
Mailing Address - Fax:
Practice Address - Street 1:671 S ROYAL POINCIANA BLVD APT 205
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-7237
Practice Address - Country:US
Practice Address - Phone:305-495-4632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-181223106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty