Provider Demographics
NPI:1720876717
Name:ECHENIQUE MARRERO, JOEL
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:ECHENIQUE MARRERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 MAGNOLIA POND DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-8300
Mailing Address - Country:US
Mailing Address - Phone:239-326-3033
Mailing Address - Fax:
Practice Address - Street 1:2977 GOODLETTE-FRANK RD N STE 14
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4613
Practice Address - Country:US
Practice Address - Phone:786-451-5307
Practice Address - Fax:239-237-5981
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-428519106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician