Provider Demographics
NPI:1891556510
Name:CARDOZA, ISIS (TFC)
Entity Type:Individual
Prefix:
First Name:ISIS
Middle Name:
Last Name:CARDOZA
Suffix:
Gender:F
Credentials:TFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 W 28TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1262
Mailing Address - Country:US
Mailing Address - Phone:786-792-1609
Mailing Address - Fax:
Practice Address - Street 1:608 W 28TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1262
Practice Address - Country:US
Practice Address - Phone:786-792-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TFC-III-07-39-2467101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty