Individual
MASIEL CHAVIANO HUERTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6480 W 25TH CT, HIALEAH, FL 33016-4373
(786) 306-9980
Mailing address
6480 W 25TH CT, HIALEAH, FL 33016-4373
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022167100
—
FL
Enumeration date
03/01/2018
Last updated
11/14/2019
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