Provider Demographics
NPI:1598112120
Name:PINERA CARMONA, DANAISY (BCBA 1-17-26384)
Entity type:Individual
Prefix:
First Name:DANAISY
Middle Name:
Last Name:PINERA CARMONA
Suffix:
Gender:F
Credentials:BCBA 1-17-26384
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 W 16TH AVE STE 41
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7161
Mailing Address - Country:US
Mailing Address - Phone:786-267-2830
Mailing Address - Fax:786-221-3333
Practice Address - Street 1:4410 W 16TH AVE STE 41
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7161
Practice Address - Country:US
Practice Address - Phone:786-267-2830
Practice Address - Fax:786-221-3333
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-17-26384103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst