Provider Demographics
NPI:1386328680
Name:PINZON, MARIANA
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:PINZON
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 1:4315 GREENBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3833
Mailing Address - Country:US
Mailing Address - Phone:754-262-1520
Mailing Address - Fax:
Practice Address - Street 1:11159 NW 39TH ST APT 201
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7573
Practice Address - Country:US
Practice Address - Phone:786-612-5077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician