Provider Demographics
NPI:1821548033
Name:LACERDA, TAMARA (BS)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:LACERDA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 NW 35TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3811
Mailing Address - Country:US
Mailing Address - Phone:786-286-0796
Mailing Address - Fax:
Practice Address - Street 1:760 NW 35TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3811
Practice Address - Country:US
Practice Address - Phone:786-286-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker