Provider Demographics
NPI:1588334254
Name:MONTALVO HERNANDEZ, DANIELA
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:MONTALVO HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18654 NW 79TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2761
Mailing Address - Country:US
Mailing Address - Phone:786-793-4776
Mailing Address - Fax:
Practice Address - Street 1:1275 W 47TH PL STE 449
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3455
Practice Address - Country:US
Practice Address - Phone:305-425-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-148548106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician