Provider Demographics
NPI:1053910026
Name:ARENCIBIA, ESTRELLA
Entity type:Individual
Prefix:
First Name:ESTRELLA
Middle Name:
Last Name:ARENCIBIA
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 1:758 SW 101ST COURT CIR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1879
Mailing Address - Country:US
Mailing Address - Phone:305-219-5949
Mailing Address - Fax:
Practice Address - Street 1:10689 N KENDALL DR STE 309
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1525
Practice Address - Country:US
Practice Address - Phone:786-536-7470
Practice Address - Fax:786-536-7951
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-21
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician