Provider Demographics
NPI:1194535054
Name:RINCON NOEL, MILENA D (RBT)
Entity type:Individual
Prefix:
First Name:MILENA
Middle Name:D
Last Name:RINCON NOEL
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 1:3670 INVERRARY DR APT 1Z
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5939
Mailing Address - Country:US
Mailing Address - Phone:954-865-2060
Mailing Address - Fax:
Practice Address - Street 1:5100 W COPANS RD STE 310
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7700
Practice Address - Country:US
Practice Address - Phone:954-825-3317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-364788251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health