Healthcare Provider Details

I. General information

NPI: 1568117380
Provider Name (Legal Business Name): ERICKA MARINA LLUBERES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 02/21/2022
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST
MIAMI FL
33136-2107
US

IV. Provider business mailing address

265 E OKEECHOBEE RD
HIALEAH FL
33010-5203
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6660
  • Fax:
Mailing address:
  • Phone: 786-210-2680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: