Healthcare Provider Details

I. General information

NPI: 1013611151
Provider Name (Legal Business Name): RACHEL LACALLE GARRIDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6303 BLUE LAGOON DR STE 400
MIAMI FL
33126-6040
US

IV. Provider business mailing address

1319 E OSCEOLA PKWY
KISSIMMEE FL
34744-1606
US

V. Phone/Fax

Practice location:
  • Phone: 316-737-9862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86381
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-262936
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: