Provider Demographics
NPI:1851865562
Name:CORZO FRANCO, DIUNED
Entity Type:Individual
Prefix:
First Name:DIUNED
Middle Name:
Last Name:CORZO FRANCO
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 1:1825 NW CORPORATE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8554
Mailing Address - Country:US
Mailing Address - Phone:561-710-3135
Mailing Address - Fax:561-710-3136
Practice Address - Street 1:12678 SW 54TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5484
Practice Address - Country:US
Practice Address - Phone:786-419-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10449106E00000X
FLRBT-18-71022106S00000X
FL1-20-42256103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician