Healthcare Provider Details

I. General information

NPI: 1396321626
Provider Name (Legal Business Name): PAULA KARINA DE LA ROTTA-PEREZ PSYD, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15800 PINES BLVD UNIT 343
PEMBROKE PINES FL
33027-1212
US

IV. Provider business mailing address

15800 PINES BLVD UNIT 343
PEMBROKE PINES FL
33027-1212
US

V. Phone/Fax

Practice location:
  • Phone: 305-425-1105
  • Fax:
Mailing address:
  • Phone: 305-336-6950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY11030
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY11030
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPY11030
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPY11030
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberPY11030
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License NumberPY11030
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: