Most Relevant Information
Provider Data
| NPI Number: | 1003668088 |
| Provider Name: | IAN PONCE VARGAS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-24-336424 |
Most Important Dates
| Enumeration Date: | 04/03/2024 |
| Last Updated: | 04/03/2024 |
Provider Practice Location
19111 NW 88TH CT
HIALEAH
FL
330186242
Practice Location Phone/Fax
| Phone: | 7866857550 |
| Fax: |
Provider Mailing Location
19111 NW 88TH CT
HIALEAH
FL
330186242
Provider Mailing Phone/Fax
| Phone: | 7866857550 |
| Fax: |