Healthcare Provider Details

I. General information

NPI: 1760039846
Provider Name (Legal Business Name): DAYNERIS MILL SALAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 CORAL WAY STE 560
CORAL GABLES FL
33145-3214
US

IV. Provider business mailing address

5218 SW 139TH CT
MIAMI FL
33175-5189
US

V. Phone/Fax

Practice location:
  • Phone: 786-238-7298
  • Fax: 786-953-7117
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: