Provider Demographics
NPI:1568277481
Name:DIAZ DE ACEVEDO, MAYBI (RBT)
Entity type:Individual
Prefix:
First Name:MAYBI
Middle Name:
Last Name:DIAZ DE ACEVEDO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 NE 204TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-5156
Mailing Address - Country:US
Mailing Address - Phone:305-527-3876
Mailing Address - Fax:
Practice Address - Street 1:1335 NE 204TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-5156
Practice Address - Country:US
Practice Address - Phone:305-527-3876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-408187106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician