Provider Demographics
NPI:1821390014
Name:CARABANTES, MARIANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:
Last Name:CARABANTES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 SW 149TH PASS
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5782
Mailing Address - Country:US
Mailing Address - Phone:305-338-0378
Mailing Address - Fax:
Practice Address - Street 1:5246 SW 8TH ST
Practice Address - Street 2:SUITE 201B
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2375
Practice Address - Country:US
Practice Address - Phone:786-472-1043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLET533AMedicare PIN
FLET533ZMedicare PIN
FL003889400Medicaid