Provider Demographics
NPI:1114701836
Name:POZO ALVAREZ, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:POZO ALVAREZ
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 1:10360 SW 216TH ST APT 107
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1701
Mailing Address - Country:US
Mailing Address - Phone:786-616-5846
Mailing Address - Fax:
Practice Address - Street 1:10360 SW 216TH ST APT 107
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1701
Practice Address - Country:US
Practice Address - Phone:786-616-5846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-125560106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty