Provider Demographics
NPI:1295342806
Name:LUACES, KARINA MARIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARINA
Middle Name:MARIA
Last Name:LUACES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 SW 90TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2415
Mailing Address - Country:US
Mailing Address - Phone:786-301-2207
Mailing Address - Fax:
Practice Address - Street 1:10205 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-3167
Practice Address - Country:US
Practice Address - Phone:305-662-2686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10923103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical