Provider Demographics
NPI:1548082266
Name:CARRAZANA, ADRIAN (RMHI)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:CARRAZANA
Suffix:
Gender:M
Credentials:RMHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 SW 122ND AVE APT 119
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-2825
Mailing Address - Country:US
Mailing Address - Phone:786-291-0514
Mailing Address - Fax:
Practice Address - Street 1:2955 PINEDA PLAZA WAY STE 209
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7307
Practice Address - Country:US
Practice Address - Phone:321-610-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health