Provider Demographics
NPI:1285131508
Name:MOLINA PLACER, DAYLI
Entity type:Individual
Prefix:
First Name:DAYLI
Middle Name:
Last Name:MOLINA PLACER
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 1:26905 SW 144TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-7503
Mailing Address - Country:US
Mailing Address - Phone:786-626-3107
Mailing Address - Fax:
Practice Address - Street 1:8755 SW 152ND AVE APT 165
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-4157
Practice Address - Country:US
Practice Address - Phone:786-626-3107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FLRBT1871634106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No251E00000XAgenciesHome Health