Provider Demographics
NPI:1982158747
Name:ALVAREZ, ROSA (RBT)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:ALVAREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2094 CHAMPIONS WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-5471
Mailing Address - Country:US
Mailing Address - Phone:786-262-0824
Mailing Address - Fax:
Practice Address - Street 1:2094 CHAMPIONS WAY
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-5471
Practice Address - Country:US
Practice Address - Phone:786-262-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246Z00000X
FLRBT15-08060106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other