Provider Demographics
NPI:1578070199
Name:FERNANDEZ DELGADO, ANNALAYS
Entity Type:Individual
Prefix:
First Name:ANNALAYS
Middle Name:
Last Name:FERNANDEZ DELGADO
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 1:2899 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4433
Mailing Address - Country:US
Mailing Address - Phone:786-308-6976
Mailing Address - Fax:
Practice Address - Street 1:2899 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4433
Practice Address - Country:US
Practice Address - Phone:786-308-6976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician