Provider Demographics
NPI:1326583311
Name:BELTRAN-GUZMAN, MARLEN
Entity Type:Individual
Prefix:MRS
First Name:MARLEN
Middle Name:
Last Name:BELTRAN-GUZMAN
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 1:11795 SW 18TH ST
Mailing Address - Street 2:APT # 9
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8719
Mailing Address - Country:US
Mailing Address - Phone:786-800-0688
Mailing Address - Fax:
Practice Address - Street 1:11795 SW 18TH ST
Practice Address - Street 2:APT # 9
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8719
Practice Address - Country:US
Practice Address - Phone:786-800-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-29
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician