Provider Demographics
NPI:1336036938
Name:SOTOMAYOR, NIUSKY
Entity type:Individual
Prefix:
First Name:NIUSKY
Middle Name:
Last Name:SOTOMAYOR
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 1:15231 NW 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1361
Mailing Address - Country:US
Mailing Address - Phone:786-643-5110
Mailing Address - Fax:
Practice Address - Street 1:7900 NW 155TH ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5844
Practice Address - Country:US
Practice Address - Phone:786-536-2037
Practice Address - Fax:786-513-2950
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-140093106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician