Healthcare Provider Details

I. General information

NPI: 1861095218
Provider Name (Legal Business Name): EMMANUEL DIAS SANCHO RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12702 SCIENCE DR
ORLANDO FL
32826-3016
US

IV. Provider business mailing address

7766 SILVERTREE TRL APT 103
ORLANDO FL
32822-8087
US

V. Phone/Fax

Practice location:
  • Phone: 407-559-4854
  • Fax:
Mailing address:
  • Phone: 360-932-2588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: