Provider Demographics
NPI:1891667382
Name:CHAVEZ, GLORIA I (RBT)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:I
Last Name:CHAVEZ
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 1:2294 SW 24TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3628
Mailing Address - Country:US
Mailing Address - Phone:786-356-0090
Mailing Address - Fax:
Practice Address - Street 1:2294 SW 24TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3628
Practice Address - Country:US
Practice Address - Phone:786-356-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT25-468817106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician