Provider Demographics
NPI:1205334562
Name:JORGE MARRERO, ISABEL (RBT-20-122131)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:JORGE MARRERO
Suffix:
Gender:F
Credentials:RBT-20-122131
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 W OKEECHOBEE RD LOT 512
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2942
Mailing Address - Country:US
Mailing Address - Phone:786-475-0312
Mailing Address - Fax:
Practice Address - Street 1:12401 W OKEECHOBEE RD LOT 512
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-2942
Practice Address - Country:US
Practice Address - Phone:786-475-0312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-122131106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician