Provider Demographics
NPI:1184480667
Name:LLERENA PAREDES, CINTHYA GABRIELA
Entity type:Individual
Prefix:
First Name:CINTHYA
Middle Name:GABRIELA
Last Name:LLERENA PAREDES
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 1:1877 SE 26TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-2445
Mailing Address - Country:US
Mailing Address - Phone:786-451-7132
Mailing Address - Fax:
Practice Address - Street 1:1877 SE 26TH TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-2445
Practice Address - Country:US
Practice Address - Phone:786-451-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-327834106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty