Provider Demographics
NPI:1013785781
Name:ARTEAGA, HANY
Entity Type:Individual
Prefix:
First Name:HANY
Middle Name:
Last Name:ARTEAGA
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 1:12401 W OKEECHOBEE RD
Mailing Address - Street 2:LOTE 187
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5909
Mailing Address - Country:US
Mailing Address - Phone:786-812-1877
Mailing Address - Fax:
Practice Address - Street 1:12401 W OKEECHOBEE RD
Practice Address - Street 2:LOTE 187
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-5909
Practice Address - Country:US
Practice Address - Phone:786-812-1877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-315518106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician