Provider Demographics
NPI:1659199107
Name:CARDENAS ADAMES, ISIS LEYDIS
Entity type:Individual
Prefix:
First Name:ISIS
Middle Name:LEYDIS
Last Name:CARDENAS ADAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 W 6TH CT APT 6
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2171
Mailing Address - Country:US
Mailing Address - Phone:786-451-3279
Mailing Address - Fax:
Practice Address - Street 1:2435 W 6TH CT APT 6
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2171
Practice Address - Country:US
Practice Address - Phone:786-451-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-381560106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician