Richard Anthony Jerez

Individual provider Active NPI Behavior Technician · Naranja, FL

NPI 1245768985 · NPPES record last updated Jan 28, 2019

Key facts

NPI
1245768985
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-18-74612 (FL)
Practice address
27501 S Dixie Hwy Ste 403
Naranja, FL 33032-8219
Phone
(786) 601-2608
Fax
(305) 647-0250
NPI assigned
May 25, 2017
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-18-74612FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Bio-Behavioral Corp. Past Accepting new patients
Mission Counseling Group, PLLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-74612 FL Yes

Addresses

Primary practice location

27501 S Dixie Hwy Ste 403
Naranja, FL 33032-8219

Mailing address

27501 S Dixie Hwy Ste 200
Naranja, FL 33032-8219
Phone (786) 601-2608

Other providers in Naranja, FL

All providers in Naranja, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.