Healthcare Provider Details

I. General information

NPI: 1669240677
Provider Name (Legal Business Name): BRAYAN VALDES CALA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E DANIA BEACH BLVD APT 1428
DANIA BEACH FL
33004-3128
US

IV. Provider business mailing address

601 E DANIA BEACH BLVD APT 1428
DANIA BEACH FL
33004-3128
US

V. Phone/Fax

Practice location:
  • Phone: 786-655-9306
  • Fax:
Mailing address:
  • Phone: 786-793-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-26-90118
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: