Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106E00000X | Assistant Behavior Analyst | ||
Y | 106S00000X | Behavior Technician | RBT20124299 | FL |
NPI | 1164037438 |
---|---|
Provider Name | Leonardo Andres Sulbaran Sanchez |
First Address | Miami, FL 33132-3011 |
Second Address | Miami, FL 33132-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2020 |
Last Update Date | 20/09/2021 |