Provider Demographics
NPI:1427801372
Name:SACASAS RODRIGUEZ, MARILYN
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:SACASAS RODRIGUEZ
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 1:11251 NW 84TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1799
Mailing Address - Country:US
Mailing Address - Phone:561-373-1947
Mailing Address - Fax:
Practice Address - Street 1:11251 NW 84TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-1799
Practice Address - Country:US
Practice Address - Phone:561-373-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide