Provider Demographics
NPI:1285984716
Name:VERDECIA, ELINA MARCIA
Entity type:Individual
Prefix:
First Name:ELINA
Middle Name:MARCIA
Last Name:VERDECIA
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 1:1951 NW 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1547
Mailing Address - Country:US
Mailing Address - Phone:305-774-9570
Mailing Address - Fax:305-774-9573
Practice Address - Street 1:1951 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1547
Practice Address - Country:US
Practice Address - Phone:305-774-9570
Practice Address - Fax:305-774-9573
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator