Provider Demographics
NPI:1104439256
Name:FERRER MUNERO, REYNALDO
Entity type:Individual
Prefix:
First Name:REYNALDO
Middle Name:
Last Name:FERRER MUNERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18725 NW 62ND AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5017
Mailing Address - Country:US
Mailing Address - Phone:305-491-5150
Mailing Address - Fax:
Practice Address - Street 1:18725 NW 62ND AVE APT 101
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5017
Practice Address - Country:US
Practice Address - Phone:305-491-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-131768106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician