Healthcare Provider Details

I. General information

NPI: 1013531581
Provider Name (Legal Business Name): MARIANA CISNEROS SILVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 NW 96TH TER APT 202
PEMBROKE PINES FL
33024-6279
US

IV. Provider business mailing address

155 NW 96TH TER BLDG 2
PEMBROKE PINES FL
33024-6269
US

V. Phone/Fax

Practice location:
  • Phone: 305-458-9264
  • Fax:
Mailing address:
  • Phone: 305-458-9264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-120212
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: