Provider Demographics
NPI:1265151369
Name:NARVAEZ, KARLA VANESSA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:VANESSA
Last Name:NARVAEZ
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 1:213 SPIRIT LANDINGS CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-5202
Mailing Address - Country:US
Mailing Address - Phone:786-209-7917
Mailing Address - Fax:
Practice Address - Street 1:ABA KIDS CONNECTION INC
Practice Address - Street 2:1300 E MICHIGAN ST. SUITE B ORLANDO
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806
Practice Address - Country:US
Practice Address - Phone:407-488-6898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB565068106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN612-518-92-745-0Medicaid
FL612518927450Medicaid