Provider Demographics
NPI:1568975928
Name:TAIN ALEMAN, MARISOL B
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:B
Last Name:TAIN ALEMAN
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 1:15118 SW 161ST PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-6451
Mailing Address - Country:US
Mailing Address - Phone:305-924-0924
Mailing Address - Fax:
Practice Address - Street 1:15118 SW 161ST PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6451
Practice Address - Country:US
Practice Address - Phone:305-924-0924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician