Provider Demographics
NPI:1881106904
Name:GUARDIOLA, DINA ESTER
Entity type:Individual
Prefix:MRS
First Name:DINA
Middle Name:ESTER
Last Name:GUARDIOLA
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 1:1350 NW 77TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-5756
Mailing Address - Country:US
Mailing Address - Phone:786-201-0969
Mailing Address - Fax:
Practice Address - Street 1:1640 NW 113TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-2656
Practice Address - Country:US
Practice Address - Phone:954-663-8086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician