Provider Demographics
NPI:1679383640
Name:LORENZO SARDINAS, HAROL DARIAN
Entity type:Individual
Prefix:
First Name:HAROL
Middle Name:DARIAN
Last Name:LORENZO SARDINAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-3445
Mailing Address - Country:US
Mailing Address - Phone:786-445-3046
Mailing Address - Fax:
Practice Address - Street 1:1271 W 79TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-3445
Practice Address - Country:US
Practice Address - Phone:786-445-3046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-25-404158106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician