Provider Demographics
NPI:1386442606
Name:JUSTI, DIANELIS BARBARA
Entity type:Individual
Prefix:
First Name:DIANELIS
Middle Name:BARBARA
Last Name:JUSTI
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 1:29510 SW 155TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-2656
Mailing Address - Country:US
Mailing Address - Phone:305-742-7824
Mailing Address - Fax:
Practice Address - Street 1:29510 SW 155TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-2656
Practice Address - Country:US
Practice Address - Phone:305-742-7824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-414818106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician