MEDICARE: LIANA DE LA CARIDAD NOVOA CASTILLO RBT

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-20-124553	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RBT-20-124-553	OTHER	FL	BACB
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356951115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANA DE LA CARIDAD NOVOA CASTILLO RBT

Provider Business Mailing Address
First Line	:	2320 N 67TH TER
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-3909
Country	:	US
Telephone Number	:	305-527-9330
Fax Number	:

Provider Business Practice Location Address
First Line	:	5040 NW 7TH ST STE 685
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3432
Country	:	US
Telephone Number	:	786-580-3737
Fax Number	:

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

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	08/06/2020

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Directions to “ LIANA DE LA CARIDAD NOVOA CASTILLO RBT” Practice Location

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