Provider Demographics
NPI:1982262473
Name:DIAZ, MIYA (BCBA)
Entity type:Individual
Prefix:
First Name:MIYA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13926 SW 52ND LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-5167
Mailing Address - Country:US
Mailing Address - Phone:305-764-4765
Mailing Address - Fax:
Practice Address - Street 1:13926 SW 52ND LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-5167
Practice Address - Country:US
Practice Address - Phone:786-870-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-57578106S00000X
FLBCBA-1-24-74748103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician