Provider Demographics
NPI:1174234819
Name:HERNANDEZ CABALLERO, DAINELYS
Entity type:Individual
Prefix:
First Name:DAINELYS
Middle Name:
Last Name:HERNANDEZ CABALLERO
Suffix:
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 1:555 NW 152ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-6615
Mailing Address - Country:US
Mailing Address - Phone:786-695-7964
Mailing Address - Fax:
Practice Address - Street 1:555 NW 152ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-6615
Practice Address - Country:US
Practice Address - Phone:786-695-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician