=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699406512
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | D-WAY THERAPY SERVICES CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/21/2022
-----------------------------------------------------
Last Update Date | 04/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9600 NW 25TH ST STE 5C
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33172-1416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-522-9889
-----------------------------------------------------
Fax | 786-803-8273
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9600 NW 25TH ST STE 5C
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33172-1416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-522-9889
-----------------------------------------------------
Fax | 786-803-8273
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DANNY MARTINEZ GONZALEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-522-9889
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------