Provider Demographics
NPI:1871853168
Name:CARRANZA, MARCELA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MARCELA
Middle Name:
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 SW 72ND AVE APT 2410
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7882
Mailing Address - Country:US
Mailing Address - Phone:786-385-4334
Mailing Address - Fax:305-631-2661
Practice Address - Street 1:7000 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-6817
Practice Address - Country:US
Practice Address - Phone:305-908-6094
Practice Address - Fax:305-631-2661
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9136103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical