Provider Demographics
NPI:1770357618
Name:JIMENEZ, DALIA (RBT)
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:JIMENEZ
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 1:3425 CARAMBOLA CIR S
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2137
Mailing Address - Country:US
Mailing Address - Phone:561-302-0044
Mailing Address - Fax:
Practice Address - Street 1:8110 ROYAL PALM BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5795
Practice Address - Country:US
Practice Address - Phone:561-494-4499
Practice Address - Fax:561-705-7501
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-302579106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician