Provider Demographics
NPI:1972952075
Name:SEMINO REYES, MANUELA SR
Entity type:Individual
Prefix:
First Name:MANUELA
Middle Name:
Last Name:SEMINO REYES
Suffix:SR
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 1:6529 W 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6717
Mailing Address - Country:US
Mailing Address - Phone:786-447-1944
Mailing Address - Fax:
Practice Address - Street 1:6529 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6717
Practice Address - Country:US
Practice Address - Phone:786-447-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2021-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-18-9048106E00000X
FL2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant