Individual
ANELYS CORZO PUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19265 NW 47TH PL, MIAMI GARDENS, FL 33055-2012
(239) 234-3604
Mailing address
19265 NW 47TH PL, MIAMI GARDENS, FL 33055-2012
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-21-12630
FL
106S00000X
Behavior Technician
RBT-19-81911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103775900
—
FL
Enumeration date
07/24/2019
Last updated
09/02/2022
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