Provider Demographics
NPI:1063268282
Name:TORRES OLIVA, SAILY
Entity type:Individual
Prefix:
First Name:SAILY
Middle Name:
Last Name:TORRES OLIVA
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 1:2460 NW 154TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-2745
Mailing Address - Country:US
Mailing Address - Phone:305-340-1599
Mailing Address - Fax:
Practice Address - Street 1:2460 NW 154TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33054-2745
Practice Address - Country:US
Practice Address - Phone:305-340-1599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-341833106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician