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General NPI Number Information
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NPI Number | 1568350817
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Entity Type | Individual
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Provider Name | DAIRON JOSE PULIDO AYESTARAN
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Gender | Male
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 8180 NW 36TH ST STE 8180NW36
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City | DORAL
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State | FL
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Zip | 33166-6645
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Country | US
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Telephone | 866-521-5307
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Fax | 305-429-5154
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Provider Business Mailing Address
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Address Line | 3000 NW 18TH AVE APT 807
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City | MIAMI
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State | FL
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Zip | 33142-6242
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Country | US
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Telephone | 305-481-4320
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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-25-444433
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License Number State | FL
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