Provider Demographics
NPI:1164720983
Name:MARIANI, MAGDALY CINTRON
Entity Type:Individual
Prefix:
First Name:MAGDALY
Middle Name:CINTRON
Last Name:MARIANI
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 1:6073 NW 167TH ST
Mailing Address - Street 2:SUITE C13
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4336
Mailing Address - Country:US
Mailing Address - Phone:305-362-5328
Mailing Address - Fax:305-362-3303
Practice Address - Street 1:6073 NW 167TH ST
Practice Address - Street 2:SUITE C13
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4336
Practice Address - Country:US
Practice Address - Phone:305-362-5328
Practice Address - Fax:305-362-3303
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9312235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000000000Medicaid