Provider Demographics
NPI:1508749904
Name:HERNANDEZ DIAZ, RICARDO (RBT)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:HERNANDEZ DIAZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12891 SW 62ND LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-5450
Mailing Address - Country:US
Mailing Address - Phone:786-397-6308
Mailing Address - Fax:786-504-7034
Practice Address - Street 1:8532 SW 8TH ST STE 290
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4054
Practice Address - Country:US
Practice Address - Phone:786-927-8048
Practice Address - Fax:786-504-7034
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-459202106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician