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General NPI Number Information
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NPI Number | 1629893433
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Entity Type | Individual
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Provider Name | SATHYA ROMERO RUEDA LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1602 OAKFIELD DR STE 205
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City | BRANDON
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State | FL
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Zip | 33511-0827
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Country | US
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Telephone | 239-690-6906
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Fax |
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Provider Business Mailing Address
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Address Line | 11084 LE JARDIN CIR APT 202
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-2861
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Country | US
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Telephone | 727-488-2363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW23821
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License Number State | FL
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