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Delaine Reves Oquendo

Behavior Analyst

Behavioral Health & Social Service Providers

5440 W 21st Ct Apt 302, Hialeah, FL 33016-2061

PECOS Enrollment

Based on the most recent information from CMS, provider Delaine Reves Oquendo does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1497242028
Provider Type
Individual
Full Name
Reves Oquendo, Delaine
Gender
Female

Sole Proprietor
Yes
Enumeration Date
4/19/2018
Last Updated
11/10/2021

Contact Information

Practice Location

5440 W 21st Ct Apt 302, Hialeah, FL 33016-2061

(305) 879-2677

Unlisted Fax

Mailing Location

5440 W 21st Ct Apt 302, Hialeah, FL 33016-2061

(305) 879-2677

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103K00000X Primary	Description Behavior Analyst Behavioral Health & Social Service Providers	License 1-21-49747 Florida
Code 106E00000X	Description Assistant Behavior Analyst Behavioral Health & Social Service Providers	License 0-20-10839 Florida
Code 106S00000X	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer Florida

Provider Identifiers

ID	Description	Issuer
ID 022143000	Description Medicaid	Issuer Unlisted Florida

Delaine Reves Oquendo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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