Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003345075 |
---|---|
Provider Name | Leo Moreira Angarica |
First Address | Miami, FL 33126-5253 |
Second Address | Miami, FL 33126-5253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2017 |
Last Update Date | 05/06/2017 |