Provider Demographics
NPI:1871201483
Name:VARELA, HARVEY
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:
Last Name:VARELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23754 SW 108TH CT
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6106
Mailing Address - Country:US
Mailing Address - Phone:305-282-1577
Mailing Address - Fax:
Practice Address - Street 1:22823 SW 113TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-7575
Practice Address - Country:US
Practice Address - Phone:305-282-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-43086103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst