Provider Demographics
NPI:1639526668
Name:SAROZA SANCHEZ, SAIDELYS
Entity Type:Individual
Prefix:
First Name:SAIDELYS
Middle Name:
Last Name:SAROZA SANCHEZ
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 1:9990 SW 224TH ST APT 104
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1599
Mailing Address - Country:US
Mailing Address - Phone:305-399-5018
Mailing Address - Fax:
Practice Address - Street 1:9990 SW 224TH ST APT 104
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1599
Practice Address - Country:US
Practice Address - Phone:305-399-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017506400Medicaid