MEDICARE: MRS. MARIA KARLA GONZALEZ SOTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst	0-25-16664	FL

General Provider Information

NPI Number	:	1700646965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA KARLA GONZALEZ SOTO

Provider Business Mailing Address
First Line	:	15811 SW 143RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-6881
Country	:	US
Telephone Number	:	786-372-5083
Fax Number	:

Provider Business Practice Location Address
First Line	:	15811 SW 143RD CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-6881
Country	:	US
Telephone Number	:	786-372-5083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	03/18/2026

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