Provider Demographics
NPI:1841013141
Name:ALVAREZ ROJAS, GERTRUDIS MARIA (RBT)
Entity type:Individual
Prefix:
First Name:GERTRUDIS
Middle Name:MARIA
Last Name:ALVAREZ ROJAS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:GERTRUDIS
Other - Middle Name:M
Other - Last Name:ALVAREZ ROJAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:16110 RAMBLING VINE DR E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1180
Mailing Address - Country:US
Mailing Address - Phone:305-926-8972
Mailing Address - Fax:
Practice Address - Street 1:3104 W WATERS AVE STE 204
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2877
Practice Address - Country:US
Practice Address - Phone:813-265-4439
Practice Address - Fax:813-513-0065
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-379079106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician