Provider Demographics
NPI:1528588449
Name:ARMENTEROS, KARLA RAFAELA
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:RAFAELA
Last Name:ARMENTEROS
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 1:777 SW 9TH AVE APT 514
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3287
Mailing Address - Country:US
Mailing Address - Phone:786-991-7643
Mailing Address - Fax:
Practice Address - Street 1:777 SW 9TH AVE, APT 514
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3287
Practice Address - Country:US
Practice Address - Phone:786-991-7643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty