Most Relevant Information
Provider Data
| NPI Number: | 1003673955 |
| Provider Name: | SAMIRA ALINA PISONERO PORTUONDO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-24-330654 |
Most Important Dates
| Enumeration Date: | 03/05/2024 |
| Last Updated: | 03/05/2024 |
Provider Practice Location
2528 10TH AVE N APT 201
LAKE WORTH
FL
334613382
Practice Location Phone/Fax
| Phone: | 7866840370 |
| Fax: |
Provider Mailing Location
2528 10TH AVE N APT 201
LAKE WORTH
FL
334613382
Provider Mailing Phone/Fax
| Phone: | 7866840370 |
| Fax: |