Healthcare Provider Details

I. General information

NPI: 1811340649
Provider Name (Legal Business Name): NAEYJALITE BAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2016
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SE 2ND AVE STE 550
MIAMI FL
33131-1601
US

IV. Provider business mailing address

1815 NW 22ND CT
MIAMI FL
33125-1305
US

V. Phone/Fax

Practice location:
  • Phone: 305-218-6596
  • Fax:
Mailing address:
  • Phone: 617-704-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3154
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: