Provider Demographics
NPI:1063038982
Name:CASAS DIAZ, ADRIANA D (BCBA)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:D
Last Name:CASAS DIAZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 NE MIAMI PL APT 3310
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1386
Mailing Address - Country:US
Mailing Address - Phone:786-616-5614
Mailing Address - Fax:
Practice Address - Street 1:1424 NE MIAMI PL APT 3310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1386
Practice Address - Country:US
Practice Address - Phone:786-616-5614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-117692106S00000X
FL1-21-46983103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician