Provider Demographics
NPI:1336989508
Name:ARAOZ BANOS, MARIA DE LOURDES
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DE LOURDES
Last Name:ARAOZ BANOS
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 1:15373 WILDFLOWER CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-4861
Mailing Address - Country:US
Mailing Address - Phone:239-944-1952
Mailing Address - Fax:
Practice Address - Street 1:15373 WILDFLOWER CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-4861
Practice Address - Country:US
Practice Address - Phone:239-944-1952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-302626106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty