Provider Demographics
NPI:1679077804
Name:RICALO, NATALIA CARIDAD (BEHAVIOR ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:CARIDAD
Last Name:RICALO
Suffix:
Gender:F
Credentials:BEHAVIOR ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6473 SW 158TH PASS
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3672
Mailing Address - Country:US
Mailing Address - Phone:786-715-5900
Mailing Address - Fax:
Practice Address - Street 1:6473 SW 158TH PASS
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3672
Practice Address - Country:US
Practice Address - Phone:786-715-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician