Provider Demographics
NPI:1629692900
Name:ENRIQUEZ CALVINO, MEYLIN AYMEE
Entity Type:Individual
Prefix:
First Name:MEYLIN
Middle Name:AYMEE
Last Name:ENRIQUEZ CALVINO
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 1:8135 NW 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4535
Mailing Address - Country:US
Mailing Address - Phone:786-817-4871
Mailing Address - Fax:
Practice Address - Street 1:8135 NW 32ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4535
Practice Address - Country:US
Practice Address - Phone:786-817-4871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician