Provider Demographics
NPI:1922880095
Name:GARRIDO DIAZ, ONIEL JOSE
Entity Type:Individual
Prefix:
First Name:ONIEL
Middle Name:JOSE
Last Name:GARRIDO DIAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33415-1265
Mailing Address - Country:US
Mailing Address - Phone:561-603-6025
Mailing Address - Fax:
Practice Address - Street 1:940 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:FL
Practice Address - Zip Code:33415-1265
Practice Address - Country:US
Practice Address - Phone:561-603-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician