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General NPI Number Information
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NPI Number | 1316731631
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Entity Type | Individual
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Provider Name | ESTEBAN SAMUEL URIZAR
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Gender | Male
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 12392 SW 82ND AVE # 12392A
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City | PINECREST
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State | FL
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Zip | 33156-5223
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Country | US
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Telephone | 146-656-1546
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Fax |
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Provider Business Mailing Address
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Address Line | 10221 SW 143RD PL
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City | MIAMI
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State | FL
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Zip | 33186-6990
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Country | US
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Telephone | 305-889-9650
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BACB1221757
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License Number State | FL
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