Provider Demographics
NPI:1740720267
Name:PAYAN, TAIRYS
Entity type:Individual
Prefix:
First Name:TAIRYS
Middle Name:
Last Name:PAYAN
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 1:11441 INTERCHANGE CIR S
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6009
Mailing Address - Country:US
Mailing Address - Phone:305-573-6333
Mailing Address - Fax:305-573-6888
Practice Address - Street 1:11441 INTERCHANGE CIR S
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6009
Practice Address - Country:US
Practice Address - Phone:305-573-6333
Practice Address - Fax:305-573-6888
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician