Provider Demographics
NPI:1215779434
Name:CASABELLA, PAOLA ANDREA
Entity type:Individual
Prefix:
First Name:PAOLA
Middle Name:ANDREA
Last Name:CASABELLA
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 1:10700 NW 7TH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3768
Mailing Address - Country:US
Mailing Address - Phone:305-877-0801
Mailing Address - Fax:
Practice Address - Street 1:10700 NW 7TH ST APT 11
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3768
Practice Address - Country:US
Practice Address - Phone:305-877-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-312173174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN