Healthcare Provider Details

I. General information

NPI: 1326796145
Provider Name (Legal Business Name): MARIA T CARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 ROSELAND DR APT 1
WEST PALM BEACH FL
33405-2294
US

IV. Provider business mailing address

443 ROSELAND DR APT 1
WEST PALM BEACH FL
33405-2294
US

V. Phone/Fax

Practice location:
  • Phone: 561-667-1334
  • Fax:
Mailing address:
  • Phone: 561-667-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-163056
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: