Provider Demographics
NPI:1427600675
Name:DIAZ ROMERO, OLAYENSYS (RBT-19-78330)
Entity Type:Individual
Prefix:
First Name:OLAYENSYS
Middle Name:
Last Name:DIAZ ROMERO
Suffix:
Gender:F
Credentials:RBT-19-78330
Other - Prefix:MRS
Other - First Name:OLAYENSYS
Other - Middle Name:
Other - Last Name:DIAZ ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11051 SW 200TH ST APT 207A
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8403
Mailing Address - Country:US
Mailing Address - Phone:305-780-0565
Mailing Address - Fax:
Practice Address - Street 1:11051 SW 200TH ST APT 207A
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8403
Practice Address - Country:US
Practice Address - Phone:305-780-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-09
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-78330106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician