Provider Demographics
NPI:1164955415
Name:GUERRA CADALZO, MARICELY
Entity type:Individual
Prefix:
First Name:MARICELY
Middle Name:
Last Name:GUERRA CADALZO
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 1:19110 NW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-3141
Mailing Address - Country:US
Mailing Address - Phone:786-674-9410
Mailing Address - Fax:
Practice Address - Street 1:19110 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-3141
Practice Address - Country:US
Practice Address - Phone:786-674-9410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst