Provider Demographics
NPI:1568206100
Name:MONTEAGUDO-ALVAREZ, CARLOS JAVIER (RBT-24-352797)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:JAVIER
Last Name:MONTEAGUDO-ALVAREZ
Suffix:
Gender:M
Credentials:RBT-24-352797
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5424 DEERBROOKE CREEK CIR APT 24
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2817
Mailing Address - Country:US
Mailing Address - Phone:813-705-5109
Mailing Address - Fax:
Practice Address - Street 1:3104 W WATERS AVE STE 204
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2877
Practice Address - Country:US
Practice Address - Phone:813-265-4439
Practice Address - Fax:813-513-0065
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-352797106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician