Provider Demographics
NPI:1740982149
Name:HERNANDEZ RAMOS, MARBELIS (RBT)
Entity type:Individual
Prefix:
First Name:MARBELIS
Middle Name:
Last Name:HERNANDEZ RAMOS
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 1:6506 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2152
Mailing Address - Country:US
Mailing Address - Phone:786-393-2415
Mailing Address - Fax:
Practice Address - Street 1:12557 NEW BRITTANY BLVD # V-26
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3651
Practice Address - Country:US
Practice Address - Phone:239-379-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-256283106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician