=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194679142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINA LYNDAKER PIRES
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/25/2026
-----------------------------------------------------
Last Update Date | 02/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 419 W 49TH ST STE 210
-----------------------------------------------------
City | HIALEAH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33012-3657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-300-8050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4920 NW 79TH AVE APT 108
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-5491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-300-8050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | 25501201
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------