Provider Demographics
NPI:1245038611
Name:SANTANA PRIEDES, MELISSA (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SANTANA PRIEDES
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20521 SW 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-5682
Mailing Address - Country:US
Mailing Address - Phone:786-397-5880
Mailing Address - Fax:
Practice Address - Street 1:20521 SW 125TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5682
Practice Address - Country:US
Practice Address - Phone:786-397-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-409716106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician