Healthcare Provider Details

I. General information

NPI: 1811290976
Provider Name (Legal Business Name): ADUA AMELIA TARRAU PROVIDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2010
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 NW 86TH PL APT 8
MIAMI FL
33126-6813
US

IV. Provider business mailing address

10180 SW 28TH ST
MIAMI FL
33165-2956
US

V. Phone/Fax

Practice location:
  • Phone: 786-355-1587
  • Fax: 786-515-9688
Mailing address:
  • Phone: 786-355-1587
  • Fax: 786-515-9688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number229699
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number229699
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number229699
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number229699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: