Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003414103 |
---|---|
Provider Name | Roman Anthony Pinheiro |
First Address | Spring Hill, FL 34604-7132 |
Second Address | Tampa, FL 33626-1602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2020 |
Last Update Date | 12/10/2020 |