Provider Demographics
NPI:1326628470
Name:NARANJO FERNANDEZ, LAURA DE LA CARIDAD SR
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:DE LA CARIDAD
Last Name:NARANJO FERNANDEZ
Suffix:SR
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 1:27842 SW 130TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8508
Mailing Address - Country:US
Mailing Address - Phone:305-570-6430
Mailing Address - Fax:
Practice Address - Street 1:27842 SW 130TH CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8508
Practice Address - Country:US
Practice Address - Phone:305-570-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20116783106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician