Provider Demographics
NPI:1487262812
Name:BERGERY, DIHANNET D JIMENEZ
Entity type:Individual
Prefix:
First Name:DIHANNET D
Middle Name:JIMENEZ
Last Name:BERGERY
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 1:9900 N KENDALL DR APT K107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1787
Mailing Address - Country:US
Mailing Address - Phone:786-317-4941
Mailing Address - Fax:
Practice Address - Street 1:9900 N KENDALL DR APT K107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1787
Practice Address - Country:US
Practice Address - Phone:786-317-4941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician