Provider Demographics
NPI:1326897729
Name:DUENAS HERNANDEZ, LARITZA (RBT)
Entity type:Individual
Prefix:
First Name:LARITZA
Middle Name:
Last Name:DUENAS HERNANDEZ
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 1:20923 SW 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5414
Mailing Address - Country:US
Mailing Address - Phone:786-316-5275
Mailing Address - Fax:
Practice Address - Street 1:20923 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5414
Practice Address - Country:US
Practice Address - Phone:786-316-5275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-325954106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician