Provider Demographics
NPI:1154869014
Name:TIEMANN, MARIA CARIDAD
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CARIDAD
Last Name:TIEMANN
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 1:11061 SW 142ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7012
Mailing Address - Country:US
Mailing Address - Phone:786-460-4606
Mailing Address - Fax:
Practice Address - Street 1:2515 FAIRWAYS DR
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1171
Practice Address - Country:US
Practice Address - Phone:786-460-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician