Provider Demographics
NPI:1508614025
Name:BRITO PAEZ, MARISET (RBT)
Entity Type:Individual
Prefix:
First Name:MARISET
Middle Name:
Last Name:BRITO PAEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20244 NW 32ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-1813
Mailing Address - Country:US
Mailing Address - Phone:786-624-0831
Mailing Address - Fax:
Practice Address - Street 1:20244 NW 32ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-1813
Practice Address - Country:US
Practice Address - Phone:786-624-0831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT231516596693106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-23-1516-596693OtherRBT