Provider Demographics
NPI:1225837859
Name:GODINEZ CARABALLO, DAIMY
Entity type:Individual
Prefix:
First Name:DAIMY
Middle Name:
Last Name:GODINEZ CARABALLO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13757 SW 160TH ST # 25
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1247
Mailing Address - Country:US
Mailing Address - Phone:645-142-9907
Mailing Address - Fax:
Practice Address - Street 1:13757 SW 160TH ST # 25
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1247
Practice Address - Country:US
Practice Address - Phone:645-142-9907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25407884106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician