Provider Demographics
NPI:1790402899
Name:DE AZA SANCHEZ, CATIA
Entity Type:Individual
Prefix:
First Name:CATIA
Middle Name:
Last Name:DE AZA 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 1:3440 NW 11TH CT APT 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-3258
Mailing Address - Country:US
Mailing Address - Phone:786-620-1652
Mailing Address - Fax:
Practice Address - Street 1:3440 NW 11TH CT APT 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-3258
Practice Address - Country:US
Practice Address - Phone:786-620-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty