Provider Demographics
NPI:1235971490
Name:PUENTE SERRANO, DAYMI
Entity type:Individual
Prefix:
First Name:DAYMI
Middle Name:
Last Name:PUENTE SERRANO
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 1:5033 NW 7TH ST APT 501
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3444
Mailing Address - Country:US
Mailing Address - Phone:786-720-3278
Mailing Address - Fax:
Practice Address - Street 1:5033 NW 7TH ST APT 501
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3444
Practice Address - Country:US
Practice Address - Phone:786-720-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-353068106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician