Provider Demographics
NPI:1285312629
Name:PASTORIZA MOREJON, JENNIFER (RBT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PASTORIZA MOREJON
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 1:2410 NW 162ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6542
Mailing Address - Country:US
Mailing Address - Phone:786-671-9625
Mailing Address - Fax:
Practice Address - Street 1:6807 W COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2116
Practice Address - Country:US
Practice Address - Phone:754-444-4171
Practice Address - Fax:754-444-4167
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-126915106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician