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1952167835
ISAIAS PENA FONSECA
JACKSONVILLE, FL
NPI
1952167835
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: FL RBT-24-325476)
Enumeration Date
2024-02-27
Last Update Date
2024-02-27
Business Address
ISAIAS PENA FONSECA
10240 FULCRUM AVE
JACKSONVILLE, FL 32256-8178
Phone number: 904-422-4966
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Mailing Address
ISAIAS PENA FONSECA
10240 FULCRUM AVE
JACKSONVILLE, FL 32256-8178
Phone number: 904-422-4966
Copy
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