Lisdenia Guanche
Individual provider Active NPI Behavior Analyst · Cutler Bay, FL
NPI 1669825980 · NPPES record last updated Nov 22, 2024
Key facts
- NPI
- 1669825980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-24-77559 (FL)
- Practice address
- 21012 SW 91St CT
Cutler Bay, FL 33189-3894 - Phone
- (305) 613-1681
- NPI assigned
- Jul 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-15-10639 | FL | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-15-10639 | FL | |
| Behavior Analyst | 103K00000X | 1-24-77559 | FL | Yes |
Addresses
Primary practice location
21012 SW 91St CT
Cutler Bay, FL 33189-3894
Mailing address
8933 SW 123Rd CT Apt 309
Miami, FL 33186-1986
Other practice location 1
3940 SW 102nd Ave
Apt 123
Miami, FL 33165-4598
Phone (305) 613-1681
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018233900 | Medicaid | FL |
Other providers in Cutler Bay, FL
- Hariette Alisia Graham
- Leslie Jerald Granberry Jr.
- Martha Maria Granja Serru
- Evan Clark Grant
- Lavonia Grant
- Valeria Guas
- Tamara Guerra Alfonso
- Elena Guerra
- Melba Guerra
- Miguel Angel Guerra
All providers in Cutler Bay, FL · Behavior Analyst in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.