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General NPI Number Information
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NPI Number | 1760046718
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Entity Type | Individual
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Provider Name | MARIA M. BECERRA DR
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Gender | Female
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 22320 MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33170-4456
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Country | US
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Telephone | 786-553-6165
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Fax |
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Provider Business Mailing Address
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Address Line | 15112 SW 140TH PL
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City | MIAMI
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State | FL
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Zip | 33186-5731
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Country | US
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Telephone | 786-553-6165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 22-180
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License Number State | FL
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