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General NPI Number Information
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NPI Number | 1942190939
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Entity Type | Individual
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Provider Name | ZULEIKA RENATA GIRALDO BASULTO
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 7975 NW 154TH ST STE 230
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5849
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Country | US
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Telephone | 305-874-7245
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Fax | 305-874-7245
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Provider Business Mailing Address
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Address Line | 12401 W OKEECHOBEE RD LOT 29
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City | HIALEAH
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State | FL
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Zip | 33018-2928
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Country | US
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Telephone | 786-510-0475
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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-25-445077
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License Number State | FL
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