Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-19-10689 | FL |
NPI | 1063045318 |
---|---|
Provider Name | Carlos A Diaz Esteban |
First Address | Miami Gardens, FL 33056-3013 |
Second Address | Miami Gardens, FL 33056-3013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2020 |
Last Update Date | 14/02/2020 |