Provider Demographics
NPI:1689282063
Name:LIMAYMANTA CARDENAS, DELIA B
Entity Type:Individual
Prefix:MISS
First Name:DELIA
Middle Name:B
Last Name:LIMAYMANTA CARDENAS
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 1:18466 NW 56TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-5331
Mailing Address - Country:US
Mailing Address - Phone:305-316-6122
Mailing Address - Fax:
Practice Address - Street 1:18466 NW 56TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-5331
Practice Address - Country:US
Practice Address - Phone:305-316-6122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-126434106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician