Provider Demographics
NPI:1124857792
Name:FERREIRA, FELIX RICARDO (RBT)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:RICARDO
Last Name:FERREIRA
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 NE 13TH AVE APT 229
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5125
Mailing Address - Country:US
Mailing Address - Phone:786-583-1276
Mailing Address - Fax:
Practice Address - Street 1:401 NE 2ND AVE STE 1
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4215
Practice Address - Country:US
Practice Address - Phone:954-662-9796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-312623106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty