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Organization
WALLMART PROPERTIES LLC
Active
Organization
WALLMART PROPERTIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A PENA (MANAGER)
(786) 356-2639
Entity
Organization
Contact information
Practice address
2905 NW 130TH AVE APT 208, SUNRISE, FL 33323-3047
(786) 356-2639
Mailing address
2905 NW 130TH AVE APT 208, SUNRISE, FL 33323-3047
(786) 356-2639
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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