Provider Demographics
NPI:1861736787
Name:CANCELA, MARIA MERCEDES (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:MERCEDES
Last Name:CANCELA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 SW 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3152
Mailing Address - Country:US
Mailing Address - Phone:305-666-3266
Mailing Address - Fax:
Practice Address - Street 1:5881 NW 151ST ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2450
Practice Address - Country:US
Practice Address - Phone:305-827-6500
Practice Address - Fax:305-827-6501
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional