Provider Demographics
NPI:1619467701
Name:CARO, MARIANA ALEJANDRA (MSW)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:ALEJANDRA
Last Name:CARO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2873 NE 30TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1974
Mailing Address - Country:US
Mailing Address - Phone:954-701-7394
Mailing Address - Fax:
Practice Address - Street 1:2717 W CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1756
Practice Address - Country:US
Practice Address - Phone:954-701-7394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW116611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical