Most Relevant Information
Provider Data
| NPI Number: | 1003673120 |
| Provider Name: | DIALIS N MORENO JEREZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/05/2024 |
| Last Updated: | 03/05/2024 |
Provider Practice Location
8972 NW 150TH TER
MIAMI LAKES
FL
330181375
Practice Location Phone/Fax
| Phone: | 3059923899 |
| Fax: |
Provider Mailing Location
8972 NW 150TH TER
MIAMI LAKES
FL
330181375
Provider Mailing Phone/Fax
| Phone: | 3059923899 |
| Fax: |