Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-55382 | FL |
N | 106E00000X | Assistant Behavior Analyst | 0-20-10854 | FL |
N | 106S00000X | Behavior Technician |
NPI | 1003475468 |
---|---|
Provider Name | Mr. Ernesto Alejandro Carta Brizuela |
First Address | Miami, FL 33144-4129 |
Second Address | Miami, FL 33193-5827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 24/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22180200 | (05) | FL |