Provider Demographics
NPI:1194308379
Name:SUAREZ LIMA, ADYS DAYANA
Entity type:Individual
Prefix:
First Name:ADYS
Middle Name:DAYANA
Last Name:SUAREZ LIMA
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 1:10490 SW 12TH TER APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3835
Mailing Address - Country:US
Mailing Address - Phone:786-370-3146
Mailing Address - Fax:
Practice Address - Street 1:10490 SW 12TH TER APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3835
Practice Address - Country:US
Practice Address - Phone:786-370-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-165527106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician