Provider Demographics
NPI:1912745753
Name:FLORES MARQUEZ, GLENDA MARIAN (RBT-24-354853)
Entity type:Individual
Prefix:
First Name:GLENDA
Middle Name:MARIAN
Last Name:FLORES MARQUEZ
Suffix:
Gender:F
Credentials:RBT-24-354853
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 SW 152ND AVE APT F-115
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4071
Mailing Address - Country:US
Mailing Address - Phone:786-387-6651
Mailing Address - Fax:
Practice Address - Street 1:8205 SW 152ND AVE APT F-115
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-4071
Practice Address - Country:US
Practice Address - Phone:786-387-6651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-354853106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician