Provider Demographics
NPI:1063281749
Name:OQUENDO, REGLA DE LA CARIDAD (RBT)
Entity type:Individual
Prefix:
First Name:REGLA DE LA CARIDAD
Middle Name:
Last Name:OQUENDO
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 1:1738 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4522
Mailing Address - Country:US
Mailing Address - Phone:305-345-5890
Mailing Address - Fax:
Practice Address - Street 1:5190 NW 167TH ST STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6338
Practice Address - Country:US
Practice Address - Phone:305-756-9947
Practice Address - Fax:305-756-9948
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-312397106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty