Provider Demographics
NPI:1760283600
Name:ROMERO RAVELO, JESSICA (RBT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ROMERO RAVELO
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W 34TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5124
Mailing Address - Country:US
Mailing Address - Phone:305-986-8212
Mailing Address - Fax:
Practice Address - Street 1:421 W 34TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5124
Practice Address - Country:US
Practice Address - Phone:305-986-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-383983106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician