Provider Demographics
NPI:1811697493
Name:CISNEROS, CLAUDIA GABRIELA I
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:GABRIELA
Last Name:CISNEROS
Suffix:I
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 1:5101 SW 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6029
Mailing Address - Country:US
Mailing Address - Phone:305-890-9271
Mailing Address - Fax:
Practice Address - Street 1:657 SOUTH DR STE 110
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-5926
Practice Address - Country:US
Practice Address - Phone:786-860-5161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician