Provider Demographics
NPI:1093407462
Name:FIGUEROA, DAVIANA
Entity Type:Individual
Prefix:
First Name:DAVIANA
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAVIANA
Other - Middle Name:D
Other - Last Name:POLANCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15302 LYMESTONE CT # 15302
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-1873
Mailing Address - Country:US
Mailing Address - Phone:929-239-7468
Mailing Address - Fax:
Practice Address - Street 1:15302 LYMESTONE CT # 15302
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-1873
Practice Address - Country:US
Practice Address - Phone:929-239-7468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician