Provider Demographics
NPI:1194407973
Name:CARRASCO PADILLA, ANISLEIDYS
Entity type:Individual
Prefix:
First Name:ANISLEIDYS
Middle Name:
Last Name:CARRASCO PADILLA
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 1:7472 W 33RD LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1792
Mailing Address - Country:US
Mailing Address - Phone:786-851-3822
Mailing Address - Fax:
Practice Address - Street 1:7472 W 33RD LN
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1792
Practice Address - Country:US
Practice Address - Phone:786-851-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician