Provider Demographics
NPI:1649096371
Name:OQUENDO FILGUEIRA, MARIELA MILAGROS
Entity type:Individual
Prefix:
First Name:MARIELA
Middle Name:MILAGROS
Last Name:OQUENDO FILGUEIRA
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 1:248 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-1903
Mailing Address - Country:US
Mailing Address - Phone:561-298-8432
Mailing Address - Fax:
Practice Address - Street 1:248 DAVIS RD
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-1903
Practice Address - Country:US
Practice Address - Phone:561-298-8432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24395618106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician