Provider Demographics
NPI:1902273972
Name:YSAC COBO, LIGIA BEATRIZ (LMT, RBT)
Entity Type:Individual
Prefix:
First Name:LIGIA
Middle Name:BEATRIZ
Last Name:YSAC COBO
Suffix:
Gender:F
Credentials:LMT, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 NW 2ND ST APT 112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4950
Mailing Address - Country:US
Mailing Address - Phone:786-759-9768
Mailing Address - Fax:
Practice Address - Street 1:11501 NW 2ND ST APT 112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4950
Practice Address - Country:US
Practice Address - Phone:786-759-9768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA71546225700000X
FLRBT-20-119875106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist