Provider Demographics
NPI:1497379440
Name:VALDES DIAZ, HANY
Entity Type:Individual
Prefix:
First Name:HANY
Middle Name:
Last Name:VALDES DIAZ
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 1:1099 NW 27TH CT APT 15
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-2969
Mailing Address - Country:US
Mailing Address - Phone:786-508-7668
Mailing Address - Fax:
Practice Address - Street 1:4443 NW 203RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-1241
Practice Address - Country:US
Practice Address - Phone:786-508-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-57021103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst