Individual
ADDIEL DOMINGUEZ DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11343 SW 228TH TER, MIAMI, FL 33170-7566
(786) 838-5577
Mailing address
11343 SW 228TH TER, MIAMI, FL 33170-7566
(786) 838-5577
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-320849
FL
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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