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General NPI Number Information
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NPI Number | 1740787225
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Entity Type | Individual
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Provider Name | DAINERYS RIVERA IZQUIERDO
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 5180 W ATLANTIC AVE STE 112
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8103
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Country | US
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Telephone | 561-674-9996
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Fax |
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Provider Business Mailing Address
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Address Line | 12475 57TH RD N
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City | WEST PALM BEACH
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State | FL
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Zip | 33411-8500
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Country | US
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Telephone | 561-386-1268
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-21-11708
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-63295
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License Number State | FL
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