Provider Demographics
NPI:1104329655
Name:ARBOLAY ALFONSO, LIZMARAY (RBT)
Entity type:Individual
Prefix:
First Name:LIZMARAY
Middle Name:
Last Name:ARBOLAY ALFONSO
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 1:6933 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2668
Mailing Address - Country:US
Mailing Address - Phone:305-720-1728
Mailing Address - Fax:
Practice Address - Street 1:8040 NW 155TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5880
Practice Address - Country:US
Practice Address - Phone:305-827-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-49284106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty