Provider Demographics
NPI:1710878996
Name:PANTOJA RUBIO, ANA CELIA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:CELIA
Last Name:PANTOJA RUBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 HANCOCK BRIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-5301
Mailing Address - Country:US
Mailing Address - Phone:702-980-4234
Mailing Address - Fax:
Practice Address - Street 1:1802 HANCOCK BRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-5301
Practice Address - Country:US
Practice Address - Phone:702-980-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-25452691106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician