Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | FL |
NPI | 1083156780 |
---|---|
Provider Name | Ramon Otero |
First Address | Hialeah, FL 33016-5503 |
Second Address | Hialeah, FL 33016-5503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2016 |
Last Update Date | 11/11/2016 |