Provider Demographics
NPI:1598477218
Name:POZO, CHABELY (REGISTERED BEHAVIOR)
Entity Type:Individual
Prefix:
First Name:CHABELY
Middle Name:
Last Name:POZO
Suffix:
Gender:F
Credentials:REGISTERED BEHAVIOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19640 NW 37 PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4923
Mailing Address - Country:US
Mailing Address - Phone:786-362-4026
Mailing Address - Fax:
Practice Address - Street 1:19640 NW 37 PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4923
Practice Address - Country:US
Practice Address - Phone:786-362-4026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-227889106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115315500Medicaid