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General NPI Number Information
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NPI Number | 1154193068
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Entity Type | Individual
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Provider Name | ANA IBIS PANDO
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Gender | Female
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 1380 NE MIAMI GARDENS DR STE 220F
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-4720
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Country | US
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Telephone | 786-523-3249
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Fax |
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Provider Business Mailing Address
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Address Line | 7943 W 2ND CT APT 101
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City | HIALEAH
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State | FL
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Zip | 33014-4380
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Country | US
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Telephone | 305-646-8960
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-23-304634
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License Number State | FL
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