Provider Demographics
NPI:1588170419
Name:RODRIGUEZ SARRIA, TAMARA ROSA
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:ROSA
Last Name:RODRIGUEZ SARRIA
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 1:261 SW 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2820
Mailing Address - Country:US
Mailing Address - Phone:786-857-3683
Mailing Address - Fax:
Practice Address - Street 1:261 SW 68TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2820
Practice Address - Country:US
Practice Address - Phone:786-857-3683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician