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General NPI Number Information
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NPI Number | 1467373084
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Entity Type | Organization
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Legal Business Name | MAREAS YOUTH AND WELLNESS
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 4020 BONNEY RD STE 105
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1765
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Country | US
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Telephone | 434-849-4295
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 BONNEY RD STE 105
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-1765
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Country | US
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Telephone | 434-849-4295
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Fax |
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Authorized Official
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Title or Position | NP
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Name | MARIANA HERRERA
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Credential | NP
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Telephone | 434-849-4295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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