Provider Demographics
NPI:1811290976
Name:TARRAU, ADUA AMELIA (PROVIDER)
Entity type:Individual
Prefix:MRS
First Name:ADUA
Middle Name:AMELIA
Last Name:TARRAU
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10180 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2956
Mailing Address - Country:US
Mailing Address - Phone:786-355-1587
Mailing Address - Fax:786-515-9688
Practice Address - Street 1:460 NW 86TH PL APT 8
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-6813
Practice Address - Country:US
Practice Address - Phone:786-355-1587
Practice Address - Fax:786-515-9688
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL229699372600000X, 376J00000X, 376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002040100Medicaid
FL462450920Medicaid