Provider Demographics
NPI:1922654466
Name:CARMENATE VALDES, ADIANEZ
Entity Type:Individual
Prefix:
First Name:ADIANEZ
Middle Name:
Last Name:CARMENATE VALDES
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 1:6425 COW PEN RD APT P110
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-6658
Mailing Address - Country:US
Mailing Address - Phone:786-222-3346
Mailing Address - Fax:
Practice Address - Street 1:6425 COW PEN RD APT P110
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6658
Practice Address - Country:US
Practice Address - Phone:786-222-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10179106E00000X
FL18-58027106S00000X
FL1-21-53849103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty