Provider Demographics
NPI:1669190906
Name:HERNANDEZ ACOSTA, ADRIANA (RBT)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:HERNANDEZ ACOSTA
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 1:252 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-1903
Mailing Address - Country:US
Mailing Address - Phone:561-614-7812
Mailing Address - Fax:
Practice Address - Street 1:6801 LAKE WORTH RD STE 115
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2965
Practice Address - Country:US
Practice Address - Phone:561-283-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-178580106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician