Healthcare Provider Details

I. General information

NPI: 1841948999
Provider Name (Legal Business Name): JORGE FELIX SANCHEZ DIAZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2022
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19811 NW 38TH PL
MIAMI GARDENS FL
33055-1905
US

IV. Provider business mailing address

19811 NW 38TH PL
MIAMI GARDENS FL
33055-1905
US

V. Phone/Fax

Practice location:
  • Phone: 786-608-1857
  • Fax:
Mailing address:
  • Phone: 786-608-1857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA1-25-86107
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: