Provider Demographics
NPI:1265206999
Name:DANTA SOTO, KARLA MARIA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:MARIA
Last Name:DANTA SOTO
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 1:14980 SW 49TH LN # 1H
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4460
Mailing Address - Country:US
Mailing Address - Phone:786-608-1642
Mailing Address - Fax:
Practice Address - Street 1:14980 SW 49TH LN # 1H
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4460
Practice Address - Country:US
Practice Address - Phone:786-608-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-307196106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician