Provider Demographics
NPI:1982200846
Name:MONTOYA POVEDA, ELIANY (RBT)
Entity Type:Individual
Prefix:
First Name:ELIANY
Middle Name:
Last Name:MONTOYA POVEDA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 SW 107TH AVE APT 2402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7351
Mailing Address - Country:US
Mailing Address - Phone:702-328-5615
Mailing Address - Fax:
Practice Address - Street 1:1813 SW 107TH AVE APT 2402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7351
Practice Address - Country:US
Practice Address - Phone:702-328-5615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-138016106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician