Provider Demographics
NPI:1477439016
Name:AYALA NUNEZ, LISDAY
Entity type:Individual
Prefix:
First Name:LISDAY
Middle Name:
Last Name:AYALA NUNEZ
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 1:14872 SW 143RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5666
Mailing Address - Country:US
Mailing Address - Phone:305-793-9528
Mailing Address - Fax:
Practice Address - Street 1:14872 SW 143RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-5666
Practice Address - Country:US
Practice Address - Phone:305-793-9528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-455573106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician