Provider Demographics
NPI:1245018837
Name:CEPERO REYES, GEINI (RBT)
Entity type:Individual
Prefix:
First Name:GEINI
Middle Name:
Last Name:CEPERO REYES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:GEINI
Other - Middle Name:
Other - Last Name:CEPERO REYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT-23-275536
Mailing Address - Street 1:79 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3717
Mailing Address - Country:US
Mailing Address - Phone:786-381-7144
Mailing Address - Fax:
Practice Address - Street 1:79 W 50TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3717
Practice Address - Country:US
Practice Address - Phone:786-381-7144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-275536106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician