Provider Demographics
NPI:1306527122
Name:CONCEPCION LLANES, JOSE R (RBT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:CONCEPCION LLANES
Suffix:
Gender:M
Credentials:RBT
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Other - Credentials:
Mailing Address - Street 1:8770 SW 12TH ST APT 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3367
Mailing Address - Country:US
Mailing Address - Phone:754-610-1254
Mailing Address - Fax:
Practice Address - Street 1:8300 NW 53RD ST STE 350
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-7712
Practice Address - Country:US
Practice Address - Phone:305-776-0728
Practice Address - Fax:561-828-3124
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician