Provider Demographics
NPI:1013360312
Name:TORRES DIAZ, MARIBEL
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:TORRES DIAZ
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 1:149 NW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-2417
Mailing Address - Country:US
Mailing Address - Phone:786-312-9289
Mailing Address - Fax:305-742-2190
Practice Address - Street 1:149 NW 48TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-2417
Practice Address - Country:US
Practice Address - Phone:786-312-9289
Practice Address - Fax:305-742-2190
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician