Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-04-1777 | |
N | 103TH0100X | Health Service | 8789 | FL |
NPI | 1104342369 |
---|---|
Provider Name | Dr. Israel A Sarasti |
First Address | Miami Beach, FL 33139-0915 |
Second Address | Hialeah, FL 33012-3657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2017 |
Last Update Date | 19/08/2017 |