Provider Demographics
NPI:1346018876
Name:DURAN LEMUS, STEPFANNY CAROLINA
Entity Type:Individual
Prefix:
First Name:STEPFANNY
Middle Name:CAROLINA
Last Name:DURAN LEMUS
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 1:2905 NE 190TH ST APT 204
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4922
Mailing Address - Country:US
Mailing Address - Phone:786-630-0612
Mailing Address - Fax:
Practice Address - Street 1:17121 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-2008
Practice Address - Country:US
Practice Address - Phone:786-955-6224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician