Provider Demographics
NPI:1902784952
Name:LORENTE VALLINA, DIANTNA EDITH
Entity type:Individual
Prefix:
First Name:DIANTNA
Middle Name:EDITH
Last Name:LORENTE VALLINA
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 1:777 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3009
Mailing Address - Country:US
Mailing Address - Phone:786-490-6307
Mailing Address - Fax:
Practice Address - Street 1:6195 W 19TH AVE APT 103
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6053
Practice Address - Country:US
Practice Address - Phone:305-988-2406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-466444106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician