Provider Demographics
NPI:1093547671
Name:CUADRAS-DIAZ, SUCHITEL
Entity type:Individual
Prefix:
First Name:SUCHITEL
Middle Name:
Last Name:CUADRAS-DIAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUCHITEL
Other - Middle Name:
Other - Last Name:CUADRAS-DIAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:268 SE VERADA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2139
Mailing Address - Country:US
Mailing Address - Phone:407-921-1521
Mailing Address - Fax:
Practice Address - Street 1:1401 SE GOLDTREE DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7584
Practice Address - Country:US
Practice Address - Phone:772-212-7539
Practice Address - Fax:772-673-8392
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-356496106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician