Provider Demographics
NPI:1578452124
Name:VERGARA CARRANZA, CLAUDIA SOFIA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SOFIA
Last Name:VERGARA CARRANZA
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 1:9730 SW 219TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1538
Mailing Address - Country:US
Mailing Address - Phone:786-278-7596
Mailing Address - Fax:
Practice Address - Street 1:9730 SW 219TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1538
Practice Address - Country:US
Practice Address - Phone:786-278-7596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-430076106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician