Provider Demographics
NPI:1447966684
Name:MONROY ANGARICA, SUSEJ (RBT)
Entity type:Individual
Prefix:
First Name:SUSEJ
Middle Name:
Last Name:MONROY ANGARICA
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 1:7279 W 24TH AVE APT 145
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6553
Mailing Address - Country:US
Mailing Address - Phone:954-707-3534
Mailing Address - Fax:
Practice Address - Street 1:7279 W 24TH AVE APT 145
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-6553
Practice Address - Country:US
Practice Address - Phone:954-707-3534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-154546106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109826600Medicaid