Provider Demographics
NPI:1366972242
Name:MARCANO, EVA NYDIA (MCAP, RMHCI)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:NYDIA
Last Name:MARCANO
Suffix:
Gender:F
Credentials:MCAP, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13534 LITTLE PARK DR APT 101
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3419
Mailing Address - Country:US
Mailing Address - Phone:813-389-9048
Mailing Address - Fax:
Practice Address - Street 1:8800 49TH ST N STE 106
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-5332
Practice Address - Country:US
Practice Address - Phone:727-544-0044
Practice Address - Fax:727-545-0125
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLIMH20144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)