Provider Demographics
NPI:1629561832
Name:PLAZA, KARLA D
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:D
Last Name:PLAZA
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 1:7763 W 30TH LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-3833
Mailing Address - Country:US
Mailing Address - Phone:786-280-1226
Mailing Address - Fax:
Practice Address - Street 1:3750 W 16TH AVE STE 218
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4648
Practice Address - Country:US
Practice Address - Phone:305-231-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34092355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant