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General NPI Number Information
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NPI Number | 1992663819
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Entity Type | Individual
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Provider Name | MARYURY DE LOS ANGELES DUQUE CARVAJAL
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Gender | Female
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 5301 N FEDERAL HWY STE 380
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City | BOCA RATON
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State | FL
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Zip | 33487-4916
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Country | US
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Telephone | 561-599-0986
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Fax |
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Provider Business Mailing Address
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Address Line | 4954 SW 25TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-6021
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Country | US
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Telephone | 305-339-6987
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1360752
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License Number State | FL
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