Individual
MARIO I MORENO GODOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
879 E 28TH ST, HIALEAH, FL 33013-3416
(786) 580-2204
Mailing address
879 E 28TH ST, HIALEAH, FL 33013-3416
(786) 580-2204
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-25-16396
FL
106S00000X
Behavior Technician
RBT-23-254841
FL
Other
Enumeration date
06/16/2023
Last updated
09/08/2025
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