Healthcare Provider Details

I. General information

NPI: 1679329650
Provider Name (Legal Business Name): ADRIANO DEL RIO CANDIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3032 SW 4TH AVE
CAPE CORAL FL
33914-4515
US

IV. Provider business mailing address

3032 SW 4TH AVE
CAPE CORAL FL
33914-4515
US

V. Phone/Fax

Practice location:
  • Phone: 239-365-9692
  • Fax:
Mailing address:
  • Phone: 239-365-9692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-335291
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: