Provider Demographics
NPI:1629741459
Name:HERNANDEZ CHAVIANO, DAINERYS
Entity Type:Individual
Prefix:
First Name:DAINERYS
Middle Name:
Last Name:HERNANDEZ CHAVIANO
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 1:850 SW 129TH PL APT 110
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2118
Mailing Address - Country:US
Mailing Address - Phone:786-670-4495
Mailing Address - Fax:
Practice Address - Street 1:850 SW 129TH PL APT 110
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-2118
Practice Address - Country:US
Practice Address - Phone:786-670-4495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-156158106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician