Provider Demographics
NPI:1457153546
Name:FIALLO, CINTHYA
Entity type:Individual
Prefix:
First Name:CINTHYA
Middle Name:
Last Name:FIALLO
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 1:850 SE 8TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5708
Mailing Address - Country:US
Mailing Address - Phone:786-450-0607
Mailing Address - Fax:
Practice Address - Street 1:850 SE 8TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5708
Practice Address - Country:US
Practice Address - Phone:786-450-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIOE0924176415106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst