Provider Demographics
NPI:1598324279
Name:DURAN, MARIAN CAROLINA
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:CAROLINA
Last Name:DURAN
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 1:10460 NW 74TH ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:MEDLEY
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2466
Mailing Address - Country:US
Mailing Address - Phone:786-287-3283
Mailing Address - Fax:
Practice Address - Street 1:10460 NW 74TH ST UNIT 303
Practice Address - Street 2:
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33178-2466
Practice Address - Country:US
Practice Address - Phone:786-287-3283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-51196103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst