Provider Demographics
NPI:1285081182
Name:LINARES FERRER, ADISNUVIA
Entity type:Individual
Prefix:
First Name:ADISNUVIA
Middle Name:
Last Name:LINARES FERRER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5122
Mailing Address - Country:US
Mailing Address - Phone:786-970-2603
Mailing Address - Fax:
Practice Address - Street 1:4901 SW 137TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-5122
Practice Address - Country:US
Practice Address - Phone:786-970-2603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT1505109106S00000X
FLBCABA-0-20-11476106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1982045290Medicaid