Provider Demographics
NPI:1952164725
Name:DEL RIO CHIANG, JEZABEL
Entity Type:Individual
Prefix:MRS
First Name:JEZABEL
Middle Name:
Last Name:DEL RIO CHIANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEZABEL
Other - Middle Name:
Other - Last Name:DEL RIO CHIANG
Other - Suffix:SR
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1380 NW 112TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-3654
Mailing Address - Country:US
Mailing Address - Phone:786-818-7261
Mailing Address - Fax:
Practice Address - Street 1:1380 NW 112TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-3654
Practice Address - Country:US
Practice Address - Phone:786-818-7261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-323144106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician