Provider Demographics
NPI:1104491323
Name:ALMANZA, SADIEL
Entity type:Individual
Prefix:
First Name:SADIEL
Middle Name:
Last Name:ALMANZA
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 1:3116 NW 101ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-1550
Mailing Address - Country:US
Mailing Address - Phone:786-395-3860
Mailing Address - Fax:
Practice Address - Street 1:14359 MIRAMAR PKWY SUITE 504
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FLORIDA
Practice Address - Zip Code:33027
Practice Address - Country:US
Practice Address - Phone:954-526-1592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA455-780-00-381-0103K00000X
FLRBT-21-167223103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst