Provider Demographics
NPI:1740999663
Name:AIZPURUA, JOSE ARMANDO (RBT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ARMANDO
Last Name:AIZPURUA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 ACORN CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-3728
Mailing Address - Country:US
Mailing Address - Phone:305-302-8346
Mailing Address - Fax:
Practice Address - Street 1:380 SEMORAN COMMERCE PL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4654
Practice Address - Country:US
Practice Address - Phone:973-652-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-240712106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician