Provider Demographics
NPI:1952132037
Name:CARABEO DIAZ, LISMEYIS (RBT)
Entity type:Individual
Prefix:
First Name:LISMEYIS
Middle Name:
Last Name:CARABEO DIAZ
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 1:4001 SW 56TH TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3746
Mailing Address - Country:US
Mailing Address - Phone:305-457-3314
Mailing Address - Fax:
Practice Address - Street 1:6191 ORANGE DR STE 6181P
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-3457
Practice Address - Country:US
Practice Address - Phone:800-484-6803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-368938106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician