Healthcare Provider Details

I. General information

NPI: 1871406892
Provider Name (Legal Business Name): MARIANA FURTADO REGISTERED INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 SE 1ST CIR
POMPANO BEACH FL
33060-7398
US

IV. Provider business mailing address

478 SE 1ST CIR
POMPANO BEACH FL
33060-7398
US

V. Phone/Fax

Practice location:
  • Phone: 954-882-5551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4628
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: