Provider Demographics
NPI:1043887045
Name:PARDO MIRANDA, ARLETY A
Entity type:Individual
Prefix:
First Name:ARLETY
Middle Name:A
Last Name:PARDO MIRANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 N F ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-2948
Mailing Address - Country:US
Mailing Address - Phone:561-541-0075
Mailing Address - Fax:
Practice Address - Street 1:529 N F ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-2948
Practice Address - Country:US
Practice Address - Phone:561-541-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician