Provider Demographics
NPI:1235932336
Name:OLIVA MAS, LIETTY CARIDAD (RBT-25-420633)
Entity type:Individual
Prefix:
First Name:LIETTY
Middle Name:CARIDAD
Last Name:OLIVA MAS
Suffix:
Gender:
Credentials:RBT-25-420633
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 WINDY WALK WAY APT 111
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7339
Mailing Address - Country:US
Mailing Address - Phone:269-216-8413
Mailing Address - Fax:
Practice Address - Street 1:3502 WINDY WALK WAY APT 111
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7339
Practice Address - Country:US
Practice Address - Phone:269-216-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-420633106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician