Provider Demographics
NPI:1972251379
Name:TAPIA, SUYOANIE
Entity Type:Individual
Prefix:
First Name:SUYOANIE
Middle Name:
Last Name:TAPIA
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 1:576 W 53RD TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2527
Mailing Address - Country:US
Mailing Address - Phone:305-301-1856
Mailing Address - Fax:
Practice Address - Street 1:4160 W 16TH AVE STE 304B
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5853
Practice Address - Country:US
Practice Address - Phone:786-482-5511
Practice Address - Fax:786-534-9166
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-67087106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-18-67087OtherREGISTERED BEHAVIOR TECHNICIAN NUMBER