Healthcare Provider Details

I. General information

NPI: 1881314185
Provider Name (Legal Business Name): GLENY ZIRIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 NE MIAMI GARDENS DR APT 158D
MIAMI FL
33179-4803
US

IV. Provider business mailing address

1481 NE MIAMI GARDENS DR APT 158D
MIAMI FL
33179-4803
US

V. Phone/Fax

Practice location:
  • Phone: 305-699-9960
  • Fax:
Mailing address:
  • Phone: 305-699-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-126418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: