Provider Demographics
NPI:1447899885
Name:LLANES RODRIGUEZ, ROXANA (RBT)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:LLANES RODRIGUEZ
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 1:465 W PARK DR # 12-3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3980
Mailing Address - Country:US
Mailing Address - Phone:305-497-4928
Mailing Address - Fax:
Practice Address - Street 1:465 W PARK DR # 12-3
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3980
Practice Address - Country:US
Practice Address - Phone:305-497-4928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-102293106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician