Provider Demographics
NPI:1427744226
Name:CARVAJAL TORRES, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CARVAJAL TORRES
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 1:19653 NW 58TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4914
Mailing Address - Country:US
Mailing Address - Phone:786-894-8086
Mailing Address - Fax:
Practice Address - Street 1:19653 NW 58TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4914
Practice Address - Country:US
Practice Address - Phone:305-799-5634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty