Provider Demographics
NPI:1700592789
Name:BARRIAL SIMON, DAYAM
Entity Type:Individual
Prefix:
First Name:DAYAM
Middle Name:
Last Name:BARRIAL SIMON
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 1:302 E 50TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1519
Mailing Address - Country:US
Mailing Address - Phone:786-820-4873
Mailing Address - Fax:
Practice Address - Street 1:302 E 50TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1519
Practice Address - Country:US
Practice Address - Phone:786-820-4873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22249780106S00000X
RBT-22-249780106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician