Provider Demographics
NPI:1730837428
Name:ACOSTA PEREZ, MONICA (RBT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ACOSTA PEREZ
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 1:21130 SW 87TH AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-7387
Mailing Address - Country:US
Mailing Address - Phone:786-564-6618
Mailing Address - Fax:
Practice Address - Street 1:1342 SE 46TH LN
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8617
Practice Address - Country:US
Practice Address - Phone:786-564-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-12
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-54013106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024697500Medicaid