Provider Demographics
NPI:1982134938
Name:MARZO, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MARZO
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 1:1975 W 44TH PL APT A504
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7457
Mailing Address - Country:US
Mailing Address - Phone:786-342-9046
Mailing Address - Fax:
Practice Address - Street 1:1975 W 44TH PL APT A504
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7457
Practice Address - Country:US
Practice Address - Phone:786-342-9046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty