Provider Demographics
NPI:1700653755
Name:LAMAS ALVAREZ, TANIA RACHEL
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:RACHEL
Last Name:LAMAS ALVAREZ
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 1:326 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4328
Mailing Address - Country:US
Mailing Address - Phone:786-546-3894
Mailing Address - Fax:
Practice Address - Street 1:9999 NE 2ND AVE STE 219
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2345
Practice Address - Country:US
Practice Address - Phone:954-871-1119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-315800106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician