Provider Demographics
NPI:1598567901
Name:RIVERO LLANTA, KAREN MARIA
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIA
Last Name:RIVERO LLANTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6660 W 22ND LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3964
Mailing Address - Country:US
Mailing Address - Phone:305-345-5848
Mailing Address - Fax:
Practice Address - Street 1:6660 W 22ND LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-3964
Practice Address - Country:US
Practice Address - Phone:305-345-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-413474106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician