Provider Demographics
NPI:1356169312
Name:FERNANDEZ TRUJILLO, DAYLIN DE LA CARIDAD (RBT)
Entity type:Individual
Prefix:
First Name:DAYLIN
Middle Name:DE LA CARIDAD
Last Name:FERNANDEZ TRUJILLO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 W LUMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6260
Mailing Address - Country:US
Mailing Address - Phone:813-324-7538
Mailing Address - Fax:813-324-7538
Practice Address - Street 1:792 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6260
Practice Address - Country:US
Practice Address - Phone:813-324-7538
Practice Address - Fax:813-324-7538
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-380390106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician