Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 103K00000X | Behavior Analyst |
NPI | 1003984568 |
---|---|
Provider Name | Mr. Ezequiel Toledo Delgado |
First Address | Miami, FL 33157-1559 |
Second Address | Miami, FL 33157-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 16/11/2021 |