Provider Demographics
NPI:1821539941
Name:REYES, MARIA DEL CARMEN
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:DEL CARMEN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1531 E 9TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-3333
Mailing Address - Country:US
Mailing Address - Phone:786-326-4948
Mailing Address - Fax:
Practice Address - Street 1:1531 E 9TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-3333
Practice Address - Country:US
Practice Address - Phone:786-326-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician