Provider Demographics
NPI:1902447485
Name:BRITO, LAURA (RBT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BRITO
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 1:24440 SW 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4406
Mailing Address - Country:US
Mailing Address - Phone:347-654-9006
Mailing Address - Fax:
Practice Address - Street 1:24440 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4406
Practice Address - Country:US
Practice Address - Phone:347-654-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-202441106S00000X
FLRBT-19-86213106S00000X
FLRBT-22-202441106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician