Healthcare Provider Details

I. General information

NPI: 1659285856
Provider Name (Legal Business Name): DARREL DILLETTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14125 NW 80TH AVE STE 304
MIAMI LAKES FL
33016-2351
US

IV. Provider business mailing address

12992 SW 32ND ST
MIRAMAR FL
33027-5339
US

V. Phone/Fax

Practice location:
  • Phone: 786-305-7222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2855663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: