Provider Demographics
NPI:1154945731
Name:CHINEA, MARIANELA SR
Entity type:Individual
Prefix:
First Name:MARIANELA
Middle Name:
Last Name:CHINEA
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIANELA
Other - Middle Name:
Other - Last Name:CHINEA
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:11180 SW 107TH ST APT 107
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8245
Mailing Address - Country:US
Mailing Address - Phone:786-444-4806
Mailing Address - Fax:
Practice Address - Street 1:11180 SW 107TH ST APT 107
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8245
Practice Address - Country:US
Practice Address - Phone:786-444-4806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL643936363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily