Healthcare Provider Details

I. General information

NPI: 1346919495
Provider Name (Legal Business Name): DIANELYS LLITERAS-RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2021
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21455 SW 112TH AVE UNIT 104
CUTLER BAY FL
33189-2908
US

IV. Provider business mailing address

21455 SW 112TH AVE UNIT 104
CUTLER BAY FL
33189-2908
US

V. Phone/Fax

Practice location:
  • Phone: 786-886-8529
  • Fax:
Mailing address:
  • Phone: 786-886-8529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-128167
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: