Provider Demographics
NPI:1558090480
Name:FIGUEREDO, DENIA
Entity Type:Individual
Prefix:
First Name:DENIA
Middle Name:
Last Name:FIGUEREDO
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 1:6107 W 22ND LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3922
Mailing Address - Country:US
Mailing Address - Phone:786-355-6544
Mailing Address - Fax:
Practice Address - Street 1:13383 SW 42ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3204
Practice Address - Country:US
Practice Address - Phone:786-534-8408
Practice Address - Fax:786-773-2612
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107382000Medicaid