Provider Demographics
NPI:1912420548
Name:EVORA MATOZINHO, REBECA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:EVORA MATOZINHO
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 NW 53RD ST APT 364
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4764
Mailing Address - Country:US
Mailing Address - Phone:786-444-9956
Mailing Address - Fax:
Practice Address - Street 1:8430 NW 8TH ST APT A1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3780
Practice Address - Country:US
Practice Address - Phone:786-444-9956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-25
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-19-10521106E00000X
FL106S00000X
FL1-22-62853103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician