MEDICARE: SONIA TILVES MORENO

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-21-156498	FL

General Provider Information

NPI Number	:	1902481229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA TILVES MORENO

Provider Business Mailing Address
First Line	:	1000 SW 93RD AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 SW 93RD AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3153
Country	:	US
Telephone Number	:	786-970-0333
Fax Number	:

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

Provider Enumeration Date	:	03/17/2021
Last Update Date	:	03/17/2021

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Directions to “ SONIA TILVES MORENO ” Practice Location

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