Provider Demographics
NPI:1598358996
Name:VERDE, ADRIANA
Entity Type:Individual
Prefix:MS
First Name:ADRIANA
Middle Name:
Last Name:VERDE
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 1:159 NW 9TH ST APT 601
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-3644
Mailing Address - Country:US
Mailing Address - Phone:305-440-7701
Mailing Address - Fax:
Practice Address - Street 1:159 NW 9TH ST APT 601
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-3644
Practice Address - Country:US
Practice Address - Phone:305-440-7701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-153370106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-21-153370OtherRBT