Most Relevant Information
Provider Data
| NPI Number: | 1003402835 |
| Provider Name: | ANTHONY DIAZ FUENTES RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-20-117960 |
Most Important Dates
| Enumeration Date: | 12/16/2020 |
| Last Updated: | 12/16/2020 |
Provider Practice Location
8925 NW 117TH ST
HIALEAH GARDENS
FL
330184139
Practice Location Phone/Fax
| Phone: | 7866204600 |
| Fax: |
Provider Mailing Location
8925 NW 117TH ST
HIALEAH GARDENS
FL
330184139
Provider Mailing Phone/Fax
| Phone: | 7866204600 |
| Fax: |