Provider Demographics
NPI:1306293956
Name:MONGE GREGORIO, OSCAR (RBT)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:MONGE GREGORIO
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 1:335 79TH ST APT 10
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-1669
Mailing Address - Country:US
Mailing Address - Phone:786-296-7024
Mailing Address - Fax:
Practice Address - Street 1:335 79TH ST APT 10
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-1669
Practice Address - Country:US
Practice Address - Phone:786-296-7024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst