Individual
AIXA LISBET PENA BERNARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8942 SW 16TH ST, MIAMI, FL 33165-7804
(305) 746-9953
Mailing address
8942 SW 16TH ST, MIAMI, FL 33165-7804
(305) 746-9953
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-365333
FL
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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