Provider Demographics
NPI:1184467102
Name:DEL RIO SARDUY, HENRY (RBT-24-355124)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:DEL RIO SARDUY
Suffix:
Gender:M
Credentials:RBT-24-355124
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 LOCH DEVON DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4282
Mailing Address - Country:US
Mailing Address - Phone:954-544-0382
Mailing Address - Fax:
Practice Address - Street 1:405 LOCH DEVON DR
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4282
Practice Address - Country:US
Practice Address - Phone:954-544-0382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-355124106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician