Provider Demographics
NPI:1003532961
Name:TORO CARMONA, LUISA FERNANDA
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:FERNANDA
Last Name:TORO CARMONA
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 1:9852 NW 56TH PL
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2823
Mailing Address - Country:US
Mailing Address - Phone:786-356-2569
Mailing Address - Fax:
Practice Address - Street 1:9852 NW 56TH PL
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-2823
Practice Address - Country:US
Practice Address - Phone:786-306-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-234866106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician