Provider Demographics
NPI:1659066025
Name:CEVERENS, MARIELA N (IBCLC CD(DONA))
Entity Type:Individual
Prefix:
First Name:MARIELA
Middle Name:N
Last Name:CEVERENS
Suffix:
Gender:F
Credentials:IBCLC CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9846 COSTA DEL SOL BLVD
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2937
Mailing Address - Country:US
Mailing Address - Phone:786-468-4839
Mailing Address - Fax:
Practice Address - Street 1:9846 COSTA DEL SOL BLVD
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2937
Practice Address - Country:US
Practice Address - Phone:786-468-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14783374J00000X
L-308315174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula