Provider Demographics
NPI:1053969501
Name:SANTANA MOLINER, AIDA ROSA (RBT)
Entity type:Individual
Prefix:MISS
First Name:AIDA
Middle Name:ROSA
Last Name:SANTANA MOLINER
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 1:25255 SW 125TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5810
Mailing Address - Country:US
Mailing Address - Phone:786-379-1882
Mailing Address - Fax:
Practice Address - Street 1:2828 CORAL WAY STE 560
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3214
Practice Address - Country:US
Practice Address - Phone:786-238-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician