Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003344268 |
---|---|
Provider Name | Anthony J Horta |
First Address | Miami, FL 33155-1757 |
Second Address | Miami, FL 33184-3132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2017 |
Last Update Date | 31/05/2017 |