Provider Demographics
NPI:1316342736
Name:SANCHEZ, KEVIN (BCBA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 SW 5TH AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3471
Mailing Address - Country:US
Mailing Address - Phone:786-603-1491
Mailing Address - Fax:
Practice Address - Street 1:658 SW 5TH AVE APT 7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3471
Practice Address - Country:US
Practice Address - Phone:786-603-1491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FL0-17-8208106E00000X
FL1-21-52738103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst