Provider Demographics
NPI:1942879358
Name:FERNADEZ, ARISLEIDY
Entity Type:Individual
Prefix:
First Name:ARISLEIDY
Middle Name:
Last Name:FERNADEZ
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 1:9840 SW 197TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-8615
Mailing Address - Country:US
Mailing Address - Phone:786-237-8177
Mailing Address - Fax:786-237-8177
Practice Address - Street 1:9840 SW 197TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8615
Practice Address - Country:US
Practice Address - Phone:786-237-8177
Practice Address - Fax:786-237-8177
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-20-119844106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician