Provider Demographics
NPI:1407721624
Name:SERRANO, ROSY L (RBT-25-474111)
Entity type:Individual
Prefix:
First Name:ROSY
Middle Name:L
Last Name:SERRANO
Suffix:
Gender:F
Credentials:RBT-25-474111
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-8829
Mailing Address - Country:US
Mailing Address - Phone:239-209-5429
Mailing Address - Fax:
Practice Address - Street 1:2601 NE 5TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993
Practice Address - Country:US
Practice Address - Phone:239-209-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-474111106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician