Individual ProviderSandra Lopez De La MazaBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address2380 SW 18th St, Miami, FL 33145-2428(786) 383-8097PECOS EnrollmentBased on the most recent information from CMS, provider Sandra Lopez De La Maza does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1073325924Provider TypeIndividualFull NameLopez De La Maza, SandraGenderFemaleSole ProprietorNoEnumeration Date1/27/2025Last Updated1/27/2025Contact InformationPractice LocationPractice Address2380 SW 18th St, Miami, FL 33145-2428Phone(786) 383-8097FaxUnlisted FaxMailing LocationMailing Address2380 SW 18th St, Miami, FL 33145-2428Phone(786) 383-8097FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseL618-329-80-900-0Florida