Healthcare Provider Details

I. General information

NPI: 1760166243
Provider Name (Legal Business Name): HELEN MARICHAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8992 NW 112TH TER
HIALEAH GARDENS FL
33018-4517
US

IV. Provider business mailing address

8992 NW 112TH TER
HIALEAH GARDENS FL
33018-4517
US

V. Phone/Fax

Practice location:
  • Phone: 786-307-8250
  • Fax:
Mailing address:
  • Phone: 786-307-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: