Provider Demographics
NPI:1679345615
Name:PARADELA ARNAIZ, MARY KARLA
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KARLA
Last Name:PARADELA ARNAIZ
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 1:12500 NE 15TH AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6062
Mailing Address - Country:US
Mailing Address - Phone:239-785-8638
Mailing Address - Fax:
Practice Address - Street 1:12500 NE 15TH AVE APT 314
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-6062
Practice Address - Country:US
Practice Address - Phone:239-785-8638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-305001106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician