Healthcare Provider Details

I. General information

NPI: 1134034721
Provider Name (Legal Business Name): GREATDIAZ BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 HYPOLUXO RD UNIT C-36
LANTANA FL
33462-4244
US

IV. Provider business mailing address

1177 HYPOLUXO RD UNIT C-36
LANTANA FL
33462-4244
US

V. Phone/Fax

Practice location:
  • Phone: 561-525-5417
  • Fax:
Mailing address:
  • Phone: 561-525-5417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ANA JOSEFA DIAZ BARREIRO
Title or Position: OWNER/MANAGER
Credential: BCBA
Phone: 561-525-5417