Healthcare Provider Details

I. General information

NPI: 1215465695
Provider Name (Legal Business Name): NIURKA DE LA CARIDAD MARRERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4355 W 16TH AVE # 211
HIALEAH FL
33012-7666
US

IV. Provider business mailing address

27500 SW 137TH CT
HOMESTEAD FL
33032-7770
US

V. Phone/Fax

Practice location:
  • Phone: 786-316-7106
  • Fax:
Mailing address:
  • Phone: 786-337-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-24-15341
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number0142475
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: