Provider Demographics
NPI:1104442029
Name:ESTRADA, MARICELA (RBT)
Entity type:Individual
Prefix:MS
First Name:MARICELA
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14894 SW 173RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-6700
Mailing Address - Country:US
Mailing Address - Phone:786-296-1213
Mailing Address - Fax:
Practice Address - Street 1:7789 NW 146TH ST STE A
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1567
Practice Address - Country:US
Practice Address - Phone:954-990-9800
Practice Address - Fax:305-907-5322
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician