Provider Demographics
NPI:1265216758
Name:RIVERO CEPERO, ROSALIA (RBT-23-288002)
Entity type:Individual
Prefix:
First Name:ROSALIA
Middle Name:
Last Name:RIVERO CEPERO
Suffix:
Gender:F
Credentials:RBT-23-288002
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 S CORAL ST
Mailing Address - Street 2:
Mailing Address - City:CLEWISTON
Mailing Address - State:FL
Mailing Address - Zip Code:33440-8699
Mailing Address - Country:US
Mailing Address - Phone:305-589-2826
Mailing Address - Fax:
Practice Address - Street 1:355 S CORAL ST
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-8699
Practice Address - Country:US
Practice Address - Phone:305-589-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-288002106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician