Provider Demographics
NPI:1134865256
Name:SANZ MARRERO, MARIA VERONICA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:VERONICA
Last Name:SANZ 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 1:10410 NW 74TH ST
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2453
Mailing Address - Country:US
Mailing Address - Phone:303-301-5349
Mailing Address - Fax:
Practice Address - Street 1:10410 NW 74TH ST
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33178-2453
Practice Address - Country:US
Practice Address - Phone:303-301-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-206834106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114078900Medicaid