Provider Demographics
NPI:1073109450
Name:FELIU ROQUE, KARELIA (BCBA)
Entity Type:Individual
Prefix:
First Name:KARELIA
Middle Name:
Last Name:FELIU ROQUE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 SW 120TH AVE FL 33330
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3328
Mailing Address - Country:US
Mailing Address - Phone:786-600-9137
Mailing Address - Fax:
Practice Address - Street 1:5841 SW 120TH AVE FL 33330
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-3328
Practice Address - Country:US
Practice Address - Phone:786-600-9137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20146250106S00000X
FL1-21-54563103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician