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General NPI Number Information
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NPI Number | 1669134003
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Entity Type | Individual
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Provider Name | IVETTE ROSARIO SOTOMAYOR-ADRIAN
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Gender | Female
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 221 SW 124TH AVE
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City | MIAMI
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State | FL
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Zip | 33184-1415
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Country | US
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Telephone | 305-213-5529
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Fax |
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Provider Business Mailing Address
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Address Line | 15380 SW 19TH TER
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City | MIAMI
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State | FL
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Zip | 33185-5725
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Country | US
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Telephone | 305-213-5529
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2584
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License Number State | FL
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