Provider Demographics
NPI:1639484082
Name:NARANJO, MAURA CARIDAD (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:CARIDAD
Last Name:NARANJO
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 NW 82 AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-537-7227
Mailing Address - Fax:305-537-7224
Practice Address - Street 1:3650 NW 82 AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166
Practice Address - Country:US
Practice Address - Phone:305-537-7227
Practice Address - Fax:305-537-7224
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14220225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT14220OtherSTATE OF FLORIDA LICENSE NUMBER