Provider Demographics
NPI:1780322958
Name:HERNANDEZ CARO, JOSE M (RBT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:HERNANDEZ CARO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:199 W 29TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5724
Mailing Address - Country:US
Mailing Address - Phone:786-930-1045
Mailing Address - Fax:786-279-0915
Practice Address - Street 1:199 W 29TH ST APT 6
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5724
Practice Address - Country:US
Practice Address - Phone:786-930-1045
Practice Address - Fax:786-279-0915
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-123597106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician