MEDICARE: MR. EDUARDO ARENCIBIA SANCHEZ SR. CBHCMS, RBT, CPMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-19-81567	FL
2	171M00000X	Case Manager/Care Coordinator	CBHCM.0104530	FL
3	251B00000X	Case Management Agency	CBHCMS.0102670	FL

General Provider Information

NPI Number	:	1841730892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDUARDO ARENCIBIA SANCHEZ SR. CBHCMS, RBT, CPMA

Provider Business Mailing Address
First Line	:	3429 W 80TH ST APT 205
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7571
Country	:	US
Telephone Number	:	813-279-9068
Fax Number	:

Provider Business Practice Location Address
First Line	:	3429 W 80TH ST APT 205
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-7571
Country	:	US
Telephone Number	:	813-279-9068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2017
Last Update Date	:	10/30/2023

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