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General NPI Number Information
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NPI Number | 1558805069
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Entity Type | Individual
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Provider Name | DANIEL DIAZ PANDO
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Gender | Male
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 20541 SW 79TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33189-2184
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Country | US
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Telephone | 786-991-3706
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Fax | 786-206-7074
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Provider Business Mailing Address
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Address Line | 20541 SW 79TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33189-2184
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Country | US
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Telephone | 786-991-3706
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Fax | 786-206-7074
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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 | BCABA-0-21-13217
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License Number State | FL
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