Provider Demographics
NPI:1023402831
Name:GATICA, CLAUDIA (MSP-ABA)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:GATICA
Suffix:
Gender:F
Credentials:MSP-ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 174TH ST
Mailing Address - Street 2:710
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3200
Mailing Address - Country:US
Mailing Address - Phone:305-318-0841
Mailing Address - Fax:
Practice Address - Street 1:290 174TH ST
Practice Address - Street 2:710
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3200
Practice Address - Country:US
Practice Address - Phone:305-318-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-16-16010222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist