Provider Demographics
NPI:1528762457
Name:ECHEZABAL RODRIGUEZ, SARAHANNIA
Entity type:Individual
Prefix:
First Name:SARAHANNIA
Middle Name:
Last Name:ECHEZABAL 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:SARYNATY2015@GMAIL.COM
Mailing Address - Street 2:6571 W 15 TH CT
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:786-740-0692
Mailing Address - Fax:
Practice Address - Street 1:SARYNATY2015@GMAIL.COM
Practice Address - Street 2:6571 W 15 TH CT
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012
Practice Address - Country:US
Practice Address - Phone:786-740-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-887175106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician