Provider Demographics
NPI:1427886001
Name:DIAZ ABAD, ANA LEYDIS (RBT)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:LEYDIS
Last Name:DIAZ ABAD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2001 LAKE BREEZE CT
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8073
Mailing Address - Country:US
Mailing Address - Phone:561-797-2553
Mailing Address - Fax:
Practice Address - Street 1:7711 N MILITARY TRL STE 212
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-6506
Practice Address - Country:US
Practice Address - Phone:561-943-3303
Practice Address - Fax:561-944-3444
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-24-362919106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician