Provider Demographics
NPI:1811777881
Name:URGELL BEJEL, ESTRELLA INOCENCIA
Entity type:Individual
Prefix:
First Name:ESTRELLA
Middle Name:INOCENCIA
Last Name:URGELL BEJEL
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 1:6850 W 14TH CT APT 7A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4541
Mailing Address - Country:US
Mailing Address - Phone:786-712-4390
Mailing Address - Fax:
Practice Address - Street 1:6850 W 14TH CT APT 7A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4541
Practice Address - Country:US
Practice Address - Phone:786-712-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-294225106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician