Provider Demographics
NPI:1245727700
Name:ACUNA, BRYAN
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:ACUNA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6962 SHARPECROFT CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2011
Mailing Address - Country:US
Mailing Address - Phone:786-218-8623
Mailing Address - Fax:
Practice Address - Street 1:6962 SHARPECROFT CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2011
Practice Address - Country:US
Practice Address - Phone:786-218-8623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician