Provider Demographics
NPI:1841791373
Name:JARQUIN VARELA, BLANCA SUCELY (LEAD ANALYST)
Entity type:Individual
Prefix:MISS
First Name:BLANCA
Middle Name:SUCELY
Last Name:JARQUIN VARELA
Suffix:
Gender:F
Credentials:LEAD ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13755 SW 147TH CIRCLE LN APT 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8207
Mailing Address - Country:US
Mailing Address - Phone:786-397-5253
Mailing Address - Fax:
Practice Address - Street 1:13755 SW 147TH CIRCLE LN APT 1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8207
Practice Address - Country:US
Practice Address - Phone:786-397-5253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23251101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health