Healthcare Provider Details

I. General information

NPI: 1831789163
Provider Name (Legal Business Name): LUISA MARIA PAREDES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 W COLUMBIA AVE
KISSIMMEE FL
34741-3436
US

IV. Provider business mailing address

4297 DELEON ST
HAINES CITY FL
33844-6509
US

V. Phone/Fax

Practice location:
  • Phone: 407-201-6255
  • Fax:
Mailing address:
  • Phone: 407-515-0189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: