Provider Demographics
NPI:1720435779
Name:VARONA, EVARISTO
Entity Type:Individual
Prefix:
First Name:EVARISTO
Middle Name:
Last Name:VARONA
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 1:971 SWAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4354
Mailing Address - Country:US
Mailing Address - Phone:786-419-2601
Mailing Address - Fax:
Practice Address - Street 1:971 SWAN AVE
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-4354
Practice Address - Country:US
Practice Address - Phone:786-419-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst