Provider Demographics
NPI:1932758323
Name:MANDINA-DIMARCO, MARIA CHRISTINA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CHRISTINA
Last Name:MANDINA-DIMARCO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:MANDINA-DIMARCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:840 37TH PL STE 2
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6502
Mailing Address - Country:US
Mailing Address - Phone:772-794-0179
Mailing Address - Fax:772-794-1091
Practice Address - Street 1:840 37TH PL STE 2
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6502
Practice Address - Country:US
Practice Address - Phone:772-794-0179
Practice Address - Fax:772-794-1091
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10581103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical