Provider Demographics
NPI:1588020614
Name:ARCOS, ANA MARIA
Entity Type:Individual
Prefix:
First Name:ANA MARIA
Middle Name:
Last Name:ARCOS
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 1:12136 MARVELWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34614-3366
Mailing Address - Country:US
Mailing Address - Phone:305-878-0140
Mailing Address - Fax:786-400-2267
Practice Address - Street 1:10330 N DALE MABRY HWY STE 210
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4404
Practice Address - Country:US
Practice Address - Phone:813-557-1525
Practice Address - Fax:813-435-2015
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-67161103K00000X
FLMT2930106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017973000Medicaid