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General NPI Number Information
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NPI Number | 1679139364
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Entity Type | Individual
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Provider Name | MODESTA SANCHEZ
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Gender | Female
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 10691 N KENDALL DR STE 305
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City | MIAMI
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State | FL
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Zip | 33176-1551
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Country | US
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Telephone | 786-703-5129
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Fax |
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Provider Business Mailing Address
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Address Line | 26205 SW 144TH AVE APT 330
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City | HOMESTEAD
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State | FL
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Zip | 33032-5666
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Country | US
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Telephone | 786-333-1114
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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-18-65565
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License Number State | FL
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