Provider Demographics
NPI:1831877919
Name:NARANJO, CARLOS ALBERTO
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:NARANJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 RUNNING HORSE RD
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-4139
Mailing Address - Country:US
Mailing Address - Phone:305-924-0250
Mailing Address - Fax:
Practice Address - Street 1:505 RUNNING HORSE RD
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-4139
Practice Address - Country:US
Practice Address - Phone:305-924-0250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-23-281646106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician