Provider Demographics
NPI:1134934623
Name:TAMARIZ, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:TAMARIZ
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 1:9935 PINEAPPLE TREE DR APT 202
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-3582
Mailing Address - Country:US
Mailing Address - Phone:561-374-3201
Mailing Address - Fax:
Practice Address - Street 1:9935 PINEAPPLE TREE DR APT 202
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-3582
Practice Address - Country:US
Practice Address - Phone:561-374-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-408788106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician