Donovan J Canales, RBT

Individual provider Active NPI Behavior Technician · Fort Lauderdale, FL

NPI 1104537281 · NPPES record last updated Dec 8, 2022

Key facts

NPI
1104537281
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
C542170980620 (FL)
Practice address
731 Arizona Ave
Fort Lauderdale, FL 33312-7319
Phone
(786) 431-9665
NPI assigned
Dec 8, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C542170980620FLMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X C542170980620 FL Yes

Addresses

Primary practice location

731 Arizona Ave
Fort Lauderdale, FL 33312-7319

Mailing address

731 Arizona Ave
Fort Lauderdale, FL 33312-7319
Phone (786) 431-9665

Other names

  • Donovan J Canales Former name

Other providers in Fort Lauderdale, FL

All providers in Fort Lauderdale, FL · Behavior Technician in Florida

Sources for this page

Verify at the official NPI Registry.