Provider Demographics
NPI:1164382230
Name:LLERENA RUIZ, DAYISMEY
Entity type:Individual
Prefix:
First Name:DAYISMEY
Middle Name:
Last Name:LLERENA RUIZ
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 1:6916 LONGMEADE LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3656
Mailing Address - Country:US
Mailing Address - Phone:407-406-8676
Mailing Address - Fax:
Practice Address - Street 1:6916 LONGMEADE LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-3656
Practice Address - Country:US
Practice Address - Phone:407-406-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-489509106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician