Provider Demographics
NPI:1962057380
Name:BETANCOURT, ARIEL (RBT-18-66832)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:BETANCOURT
Suffix:
Gender:M
Credentials:RBT-18-66832
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 W FLAGLER ST APT 6
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1624
Mailing Address - Country:US
Mailing Address - Phone:786-440-9006
Mailing Address - Fax:561-828-3124
Practice Address - Street 1:3905 WEST FLAGLER ST
Practice Address - Street 2:APT# 6
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:786-440-9006
Practice Address - Fax:561-828-3124
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-66832106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician