Healthcare Provider Details

I. General information

NPI: 1962059329
Provider Name (Legal Business Name): ANILEIDYS RODRIGUEZ NUNEZ BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 BRANCH ST
HOLLYWOOD FL
33024-5702
US

IV. Provider business mailing address

6601 BRANCH ST
HOLLYWOOD FL
33024-5702
US

V. Phone/Fax

Practice location:
  • Phone: 305-859-5257
  • Fax:
Mailing address:
  • Phone: 305-859-5257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number19-96121
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-15881
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: