Most Relevant Information
Provider Data
| NPI Number: | 1003676560 |
| Provider Name: | MIRYAM CEBALLOS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/21/2024 |
| Last Updated: | 03/21/2024 |
Provider Practice Location
5400 S UNIVERSITY DR STE 502
DAVIE
FL
333285313
Practice Location Phone/Fax
| Phone: | 8887540398 |
| Fax: |
Provider Mailing Location
6416 NW 5TH WAY
FORT LAUDERDALE
FL
333096112
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |