Provider Demographics
NPI:1811719735
Name:RIQUENE DE LA TORRE, MARITZA (RBT-24-388991)
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:RIQUENE DE LA TORRE
Suffix:
Gender:F
Credentials:RBT-24-388991
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 SUNRISE LAKES BLVD APT 201
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-1518
Mailing Address - Country:US
Mailing Address - Phone:954-325-1233
Mailing Address - Fax:
Practice Address - Street 1:8325 SUNRISE LAKES BLVD APT 201
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-1518
Practice Address - Country:US
Practice Address - Phone:954-325-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-388991106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician