Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-21-11916 | FL |
N | 106S00000X | Behavior Technician | RBT-19-88792 | FL |
NPI | 1023678505 |
---|---|
Provider Name | Elier Martinez Castro |
First Address | Tampa, FL 33614-4836 |
Second Address | Tampa, FL 33626-1602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2019 |
Last Update Date | 12/05/2021 |