Provider Demographics
NPI:1891400677
Name:NADCHAR DEL ROSARIO, AMAYA
Entity Type:Individual
Prefix:
First Name:AMAYA
Middle Name:
Last Name:NADCHAR DEL ROSARIO
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 1:19712 SW 120TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-4347
Mailing Address - Country:US
Mailing Address - Phone:786-771-9611
Mailing Address - Fax:
Practice Address - Street 1:19712 SW 120TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4347
Practice Address - Country:US
Practice Address - Phone:786-771-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-249753106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician