Provider Demographics
NPI:1366111551
Name:KAHWATI LANDA, CLAUDIA GEORGINA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:GEORGINA
Last Name:KAHWATI LANDA
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 1:13770 SW 82ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4054
Mailing Address - Country:US
Mailing Address - Phone:786-280-9115
Mailing Address - Fax:
Practice Address - Street 1:13770 SW 82ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4054
Practice Address - Country:US
Practice Address - Phone:786-280-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-184082106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician