Provider Demographics
NPI:1215777586
Name:FIGUEREDO MANRESA, NIURKA DOLORES
Entity type:Individual
Prefix:
First Name:NIURKA
Middle Name:DOLORES
Last Name:FIGUEREDO MANRESA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 E BOND DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7022
Mailing Address - Country:US
Mailing Address - Phone:561-574-7467
Mailing Address - Fax:
Practice Address - Street 1:2064 E BOND DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-7022
Practice Address - Country:US
Practice Address - Phone:561-574-7467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-25
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-151166106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty