Healthcare Provider Details

I. General information

NPI: 1871458877
Provider Name (Legal Business Name): DARIEL MARTIN GUANCHE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 E 6TH ST APT 22
HIALEAH FL
33010-4880
US

IV. Provider business mailing address

119 E 6TH ST APT 22
HIALEAH FL
33010-4880
US

V. Phone/Fax

Practice location:
  • Phone: 786-867-3317
  • Fax:
Mailing address:
  • Phone: 786-867-3317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: