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General NPI Number Information
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NPI Number | 1427580497
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Entity Type | Individual
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Provider Name | MERCEDES BEATRIZ DIEGO
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Gender | Female
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2000 NW 150TH AVE STE 2112
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2870
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Country | US
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Telephone | 888-880-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 NW 150TH AVE STE 2112
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-2870
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Country | US
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Telephone | 754-264-8779
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-21-12634
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-78751
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License Number State | FL
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