Individual
ANA IVIS MONTOYA MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2950 NW 159TH ST, MIAMI GARDENS, FL 33054-6834
(813) 410-3416
Mailing address
2950 NW 159TH ST, MIAMI GARDENS, FL 33054-6834
(813) 410-3416
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-139721
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-139721
BACB
FL
Enumeration date
02/18/2021
Last updated
02/18/2021
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