Provider Demographics
NPI:1083413280
Name:TRUJILLO ABREU, MARIAM DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:DE LA CARIDAD
Last Name:TRUJILLO ABREU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9682 FONTAINEBLEAU BLVD APT 306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4121
Mailing Address - Country:US
Mailing Address - Phone:346-563-3493
Mailing Address - Fax:
Practice Address - Street 1:9682 FONTAINEBLEAU BLVD APT 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4121
Practice Address - Country:US
Practice Address - Phone:346-563-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician