Provider Demographics
NPI:1972213452
Name:DIAZ LIMA, OSCAR (RBT-22-244768)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:DIAZ LIMA
Suffix:
Gender:M
Credentials:RBT-22-244768
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6362 NW 179TH ST
Mailing Address - Street 2:APT 211
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015
Mailing Address - Country:US
Mailing Address - Phone:786-328-3710
Mailing Address - Fax:
Practice Address - Street 1:6362 NW 179TH ST
Practice Address - Street 2:APT 211
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015
Practice Address - Country:US
Practice Address - Phone:786-328-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-244768106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician