Healthcare Provider Details

I. General information

NPI: 1932014131
Provider Name (Legal Business Name): LATSHALETTE CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20641 NW 17TH AVE APT 101
MIAMI GARDENS FL
33056-5090
US

IV. Provider business mailing address

20641 NW 17TH AVE APT 101
MIAMI GARDENS FL
33056-5090
US

V. Phone/Fax

Practice location:
  • Phone: 786-879-2072
  • Fax: 786-879-2072
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: