Provider Demographics
NPI:1528845021
Name:RIERA QUINTANA, TATIANA (RBT-23-278406)
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:RIERA QUINTANA
Suffix:
Gender:F
Credentials:RBT-23-278406
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6287 W 15TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6205
Mailing Address - Country:US
Mailing Address - Phone:786-835-4720
Mailing Address - Fax:
Practice Address - Street 1:6287 W 15TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6205
Practice Address - Country:US
Practice Address - Phone:786-835-4720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-278406106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician