MEDICARE: MRS. DAYANA VALDES CONDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1790514727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAYANA VALDES CONDE

Provider Business Mailing Address
First Line	:	7012 NW 179TH ST APT 110
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5415
Country	:	US
Telephone Number	:	786-299-7346
Fax Number	:

Provider Business Practice Location Address
First Line	:	7012 NW 179TH ST APT 110
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5415
Country	:	US
Telephone Number	:	786-299-7346
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	10/20/2024

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