Provider Demographics
NPI:1245612464
Name:URIA, MARIO SR (MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIO
Middle Name:
Last Name:URIA
Suffix:SR
Gender:M
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5085 NW 7TH ST APT 814
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3455
Mailing Address - Country:US
Mailing Address - Phone:786-444-4521
Mailing Address - Fax:
Practice Address - Street 1:15924 SW 92ND AVE BAY FL33157
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1842
Practice Address - Country:US
Practice Address - Phone:305-793-1413
Practice Address - Fax:786-452-1200
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLU625540534510104100000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker