Provider Demographics
NPI:1134943624
Name:PARDO NUNEZ, DAYANIS
Entity type:Individual
Prefix:
First Name:DAYANIS
Middle Name:
Last Name:PARDO NUNEZ
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 1:1600 S LE JEUNE RD APT 6
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3849
Mailing Address - Country:US
Mailing Address - Phone:561-629-0194
Mailing Address - Fax:
Practice Address - Street 1:1600 S LE JEUNE RD APT 6
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3849
Practice Address - Country:US
Practice Address - Phone:561-629-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24392291106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty