Provider Demographics
NPI:1447025754
Name:SARDINAS MARRERO, NADIA
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:SARDINAS MARRERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 SW 94TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3072
Mailing Address - Country:US
Mailing Address - Phone:305-322-0898
Mailing Address - Fax:
Practice Address - Street 1:1380 NE MIAMI GARDENS DR STE 220F
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4720
Practice Address - Country:US
Practice Address - Phone:786-523-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician