Provider Demographics
NPI:1982290805
Name:TORRES OQUENDO, MAYELIN (RBT)
Entity type:Individual
Prefix:
First Name:MAYELIN
Middle Name:
Last Name:TORRES OQUENDO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20411 SW 125TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5622
Mailing Address - Country:US
Mailing Address - Phone:786-328-7346
Mailing Address - Fax:
Practice Address - Street 1:20411 SW 125TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5622
Practice Address - Country:US
Practice Address - Phone:786-328-7346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20147029106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-20147029OtherBCBA