Provider Demographics
NPI:1366643801
Name:PIERRE, DAYMIS (MS)
Entity Type:Individual
Prefix:
First Name:DAYMIS
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DAYMIS
Other - Middle Name:
Other - Last Name:BETANCOURT VILLALBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15381 SW 21ST LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5731
Mailing Address - Country:US
Mailing Address - Phone:305-300-1645
Mailing Address - Fax:
Practice Address - Street 1:15381 SW 21ST LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5731
Practice Address - Country:US
Practice Address - Phone:305-300-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001705000Medicaid