Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-20-11281 | FL |
N | 106S00000X | Behavior Technician |
NPI | 1073019865 |
---|---|
Provider Name | Gilberto Hurtado Perez |
First Address | Hollywood, FL 33020-3846 |
Second Address | Hollywood, FL 33020-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2018 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019624600 | (05) | FL |