Healthcare Provider Details

I. General information

NPI: 1104233576
Provider Name (Legal Business Name): MARIA TERESA NEIRA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17900 NW 5TH ST STE 103
PEMBROKE PINES FL
33029-2809
US

IV. Provider business mailing address

6366 NW 113TH CT
DORAL FL
33178-3605
US

V. Phone/Fax

Practice location:
  • Phone: 954-388-0800
  • Fax:
Mailing address:
  • Phone: 305-305-9983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27624
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: