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General NPI Number Information
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NPI Number | 1447962436
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Entity Type | Individual
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Provider Name | DIANA MORERA
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Gender | Female
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Dates
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Enumeration Date | 12/21/2022
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 28221 SW 162ND AVE
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City | HOMESTEAD
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State | FL
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Zip | 33033-1147
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Country | US
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Telephone | 786-247-9116
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Fax |
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Provider Business Mailing Address
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Address Line | 12797 SW 250TH TER
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City | HOMESTEAD
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State | FL
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Zip | 33032-9088
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-22-249803
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License Number State | FL
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