Provider Demographics
NPI:1619752573
Name:GARCIA SARAIBA, DIANNY
Entity Type:Individual
Prefix:
First Name:DIANNY
Middle Name:
Last Name:GARCIA SARAIBA
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 1:3152 SW 2ND ST APT U
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2758
Mailing Address - Country:US
Mailing Address - Phone:786-260-7872
Mailing Address - Fax:
Practice Address - Street 1:3152 SW 2ND ST APT U
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2758
Practice Address - Country:US
Practice Address - Phone:786-260-7872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-121750106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician