Healthcare Provider Details

I. General information

NPI: 1285574665
Provider Name (Legal Business Name): MAYUMI DE ARMAS CANOVAS BEHAVIOR TECHNICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17948 NW 59TH AVE UNIT 103
HIALEAH FL
33015-5174
US

IV. Provider business mailing address

7115 NW 179TH ST APT 204
HIALEAH FL
33015-6103
US

V. Phone/Fax

Practice location:
  • Phone: 305-505-7012
  • Fax:
Mailing address:
  • Phone: 305-505-7012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-499629
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: