Provider Demographics
NPI:1508646811
Name:MEIRELES, MARELYS
Entity Type:Individual
Prefix:MRS
First Name:MARELYS
Middle Name:
Last Name:MEIRELES
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 1:1871 W 62ND ST APT 103
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6035
Mailing Address - Country:US
Mailing Address - Phone:305-608-0996
Mailing Address - Fax:
Practice Address - Street 1:1871 W 62ND ST APT 103
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6035
Practice Address - Country:US
Practice Address - Phone:305-608-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-301051106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician