Healthcare Provider Details

I. General information

NPI: 1922886688
Provider Name (Legal Business Name): THALIA BARZAGA QUIROGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17221 NW 94TH CT APT 307
HIALEAH FL
33018-4362
US

IV. Provider business mailing address

17221 NW 94TH CT APT 307
HIALEAH FL
33018-4362
US

V. Phone/Fax

Practice location:
  • Phone: 786-919-3550
  • Fax:
Mailing address:
  • Phone: 786-919-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2831155
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: