Provider Demographics
NPI:1083029672
Name:PAZ, LUISA FERNANDA
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:FERNANDA
Last Name:PAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUISA
Other - Middle Name:FERNANDA
Other - Last Name:PEREZ-ALBORNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13839 FAIRWAY ISLAND DR
Mailing Address - Street 2:1126
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-5244
Mailing Address - Country:US
Mailing Address - Phone:347-510-5300
Mailing Address - Fax:
Practice Address - Street 1:108 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-2319
Practice Address - Country:US
Practice Address - Phone:407-846-0023
Practice Address - Fax:407-935-1878
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst