Healthcare Provider Details

I. General information

NPI: 1730750738
Provider Name (Legal Business Name): KARLA QUIJANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 WALTHAM AVE
ORLANDO FL
32809-4207
US

IV. Provider business mailing address

3171 FOREST BEND RD UNIT 303
KISSIMMEE FL
34746-2037
US

V. Phone/Fax

Practice location:
  • Phone: 786-353-2900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberRBT-25-493939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: