Healthcare Provider Details

I. General information

NPI: 1952205965
Provider Name (Legal Business Name): DAYAMI CERVANTES MADRIGAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 LANTANA RD APT 2404
LAKE WORTH FL
33462-0930
US

IV. Provider business mailing address

2450 LANTANA RD APT 2404
LAKE WORTH FL
33462-0930
US

V. Phone/Fax

Practice location:
  • Phone: 863-441-5815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26-2853838
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: