Juan Pablo Fung Collazo
Behavior Technician in Miami, FL. Individual provider (NPI-1).
NPI number1962285486
StatusActive
Last updated in NPPESAug 17, 2023
Details
- NPI
- 1962285486
- Entity type
- Individual (NPI-1)
- Name
- Juan Pablo Fung Collazo
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 17, 2023
- Certification date
- Aug 17, 2023
- Last updated
- Aug 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-23-279286 | FL | Yes |
Practice location
12485 Sw 137th Ave Ste 106Miami, FL 33186-4215
Phone 786-250-4423
Mailing address
13100 Sw 92nd Ave Apt 206Miami, FL 33176-5776
Phone 786-804-2969
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