Healthcare Provider Details

I. General information

NPI: 1992645980
Provider Name (Legal Business Name): MARIA KARLA DOMINGUEZ PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9342 NW 120TH ST APT 425
HIALEAH GARDENS FL
33018-4188
US

IV. Provider business mailing address

9342 NW 120TH ST APT 425
HIALEAH GARDENS FL
33018-4188
US

V. Phone/Fax

Practice location:
  • Phone: 786-721-2986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-483703
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: