Provider Demographics
NPI:1336483247
Name:CAUDIA L UBFAL PA
Entity Type:Organization
Organization Name:CAUDIA L UBFAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:UBFAL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-290-7855
Mailing Address - Street 1:2999 NE 191 STREET
Mailing Address - Street 2:SUITE 705
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3123
Mailing Address - Country:US
Mailing Address - Phone:786-290-7855
Mailing Address - Fax:
Practice Address - Street 1:2999 NE 191 STREET
Practice Address - Street 2:SUITE 705
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33180-3123
Practice Address - Country:US
Practice Address - Phone:786-290-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty