Vivas, Deidre

Vivas, Deidre is an sole proprietor health care provider with primary practice located at 5232 Nw 112Th Pl , Doral FL 33178-3503. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Vivas, Deidre can be contacted via phone (786) 942-4099.

Contact Information

Primary practice address
5232 Nw 112Th Pl Doral FL 33178-3503
Phone: (786) 942-4099
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1780769208
LBN Legal business name Vivas, Deidre
Credentials BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2006
Last updated Mar 27th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780769208 NPPES
Florida MEDICAID 811887600
Florida MEDICAID 018383100

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