Provider Demographics
NPI:1891563144
Name:LARA CANIZARES, CLAUDIA C (CBHCMS)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDIA
Middle Name:C
Last Name:LARA CANIZARES
Suffix:
Gender:F
Credentials:CBHCMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3600 NW 102ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-1538
Mailing Address - Country:US
Mailing Address - Phone:786-973-5266
Mailing Address - Fax:305-967-8446
Practice Address - Street 1:306 ALCAZAR AVE STE 205
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4331
Practice Address - Country:US
Practice Address - Phone:305-967-8725
Practice Address - Fax:305-967-8446
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0102519251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management