Provider Demographics
NPI:1225485923
Name:BUENO, BERKY
Entity Type:Individual
Prefix:
First Name:BERKY
Middle Name:
Last Name:BUENO
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 1:10300 SW 212TH ST
Mailing Address - Street 2:APT 6
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3945
Mailing Address - Country:US
Mailing Address - Phone:786-488-4388
Mailing Address - Fax:
Practice Address - Street 1:11890 SW 8TH ST
Practice Address - Street 2:SUITE 309
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184
Practice Address - Country:US
Practice Address - Phone:305-220-6060
Practice Address - Fax:888-247-5059
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other