Provider Demographics
NPI:1437973088
Name:MACHADO PINON, EDDY (RBT-24-392376)
Entity type:Individual
Prefix:
First Name:EDDY
Middle Name:
Last Name:MACHADO PINON
Suffix:
Gender:M
Credentials:RBT-24-392376
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 NE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-1310
Mailing Address - Country:US
Mailing Address - Phone:305-498-0738
Mailing Address - Fax:
Practice Address - Street 1:917 NE 4TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-1310
Practice Address - Country:US
Practice Address - Phone:305-498-0738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-392376106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician