Provider Demographics
NPI:1720774227
Name:TAMARIT VALDES, MILAGROS
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:
Last Name:TAMARIT VALDES
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 1:7650 W 34TH LN UNIT 202
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-5027
Mailing Address - Country:US
Mailing Address - Phone:786-308-6532
Mailing Address - Fax:
Practice Address - Street 1:1660 SOUTHERN BLVD STE C
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-3219
Practice Address - Country:US
Practice Address - Phone:561-653-1245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-262283106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician