Provider Demographics
NPI:1932708294
Name:MARRERO ESPINOSA, MAITE
Entity Type:Individual
Prefix:
First Name:MAITE
Middle Name:
Last Name:MARRERO ESPINOSA
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 1:7850 NW 3RD ST APT 101
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-1267
Mailing Address - Country:US
Mailing Address - Phone:561-294-6399
Mailing Address - Fax:
Practice Address - Street 1:7850 NW 3RD ST APT 101
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-1267
Practice Address - Country:US
Practice Address - Phone:561-294-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst