=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568279446
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LIENNY SANCHEZ CARDENAS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2024
-----------------------------------------------------
Last Update Date | 12/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1875 NE 169TH ST APT 18
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33162-3056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-879-6264
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1875 NE 169TH ST APT 18
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33162-3056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-879-6264
-----------------------------------------------------
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 | 24-399687
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------