Provider Demographics
NPI:1306719216
Name:MACIAS DE ARMAS, MARYAN
Entity type:Individual
Prefix:
First Name:MARYAN
Middle Name:
Last Name:MACIAS DE ARMAS
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 1:346 BELL BLVD S
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-9794
Mailing Address - Country:US
Mailing Address - Phone:786-922-6422
Mailing Address - Fax:
Practice Address - Street 1:346 BELL BLVD S
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33974-9794
Practice Address - Country:US
Practice Address - Phone:786-922-6422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-473678106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician