Provider Demographics
NPI:1447928791
Name:QUINTANA, ZOBEIDA (RBT-20-137753)
Entity type:Individual
Prefix:
First Name:ZOBEIDA
Middle Name:
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:RBT-20-137753
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 W 62ND ST APT 217
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6036
Mailing Address - Country:US
Mailing Address - Phone:786-237-7203
Mailing Address - Fax:
Practice Address - Street 1:1871 W 62ND ST APT 217
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6036
Practice Address - Country:US
Practice Address - Phone:786-237-7203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-20-1337753106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician