Individual
FLOR DE MARIA MACAVILCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
930 NE 155TH ST, NORTH MIAMI BEACH, FL 33162-5310
(786) 267-2919
Mailing address
930 NE 155TH ST, NORTH MIAMI BEACH, FL 33162-5310
(786) 267-2919
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMP102653
FL
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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