Healthcare Provider Details

I. General information

NPI: 1689593865
Provider Name (Legal Business Name): MARIA DE ACHAVAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8175 NW 12TH ST STE 119
DORAL FL
33126-1828
US

IV. Provider business mailing address

8175 NW 12TH ST STE 119
DORAL FL
33126-1828
US

V. Phone/Fax

Practice location:
  • Phone: 786-362-5981
  • Fax:
Mailing address:
  • Phone: 786-362-5981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28068
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: