Provider Demographics
NPI:1467275073
Name:GUEVARA ZAYAS, JOSE (RBT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:GUEVARA ZAYAS
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:ERNESTO
Other - Last Name:GUEVARA ZAYAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4520 DAVIS CT
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-9534
Mailing Address - Country:US
Mailing Address - Phone:863-668-1061
Mailing Address - Fax:
Practice Address - Street 1:4520 DAVIS CT
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-9534
Practice Address - Country:US
Practice Address - Phone:863-668-1061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-02
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-389856106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician