Provider Demographics
NPI:1285186361
Name:SOCA, ELAYNE
Entity Type:Individual
Prefix:
First Name:ELAYNE
Middle Name:
Last Name:SOCA
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 1:17005 SW 93RD ST APT 4-106
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1168
Mailing Address - Country:US
Mailing Address - Phone:786-245-1764
Mailing Address - Fax:
Practice Address - Street 1:15070 SW 116TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6802
Practice Address - Country:US
Practice Address - Phone:786-245-1764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician