Healthcare Provider Details

I. General information

NPI: 1992301659
Provider Name (Legal Business Name): MARISOL SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7971 RIVIERA BLVD STE 203
MIRAMAR FL
33023-6446
US

IV. Provider business mailing address

13255 SW 7TH CT APT 414D
PEMBROKE PINES FL
33027-1824
US

V. Phone/Fax

Practice location:
  • Phone: 305-891-5451
  • Fax: 561-634-2814
Mailing address:
  • Phone: 305-342-5891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-120379
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: