Provider Demographics
NPI:1578350096
Name:PEREZ DE MEDINA HERNANDEZ, DAYANA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:DAYANA
Middle Name:DE LA CARIDAD
Last Name:PEREZ DE MEDINA HERNANDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2722
Mailing Address - Country:US
Mailing Address - Phone:786-794-6078
Mailing Address - Fax:
Practice Address - Street 1:210 E 19TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2722
Practice Address - Country:US
Practice Address - Phone:786-794-6078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-327989106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician