Individual
LAZARO R MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
1471 NW 10TH ST, HOMESTEAD, FL 33030
(786) 571-3231
Mailing address
1471 NW 10TH ST, HOMESTEAD, FL 33030-3823
(786) 571-3231
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-21-13273
FL
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
55023
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-21-13273
BEHAVIOR ANALYST CERTIFICATION BOARD
—
01
—
CBHCMS100704
FLORIDA CERTIFICATION BOARD
FL
Enumeration date
08/08/2012
Last updated
12/12/2024
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