Provider Demographics
NPI:1043893597
Name:PENA, CARIDAD MARIA
Entity Type:Individual
Prefix:
First Name:CARIDAD
Middle Name:MARIA
Last Name:PENA
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 1:950 N KROME AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4443
Mailing Address - Country:US
Mailing Address - Phone:305-246-0210
Mailing Address - Fax:305-246-0310
Practice Address - Street 1:950 N KROME AVE STE 408
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4443
Practice Address - Country:US
Practice Address - Phone:305-246-0210
Practice Address - Fax:305-246-0310
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical