MEDICARE: WILLIAMS ALBERTO PARRA MONTANO

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1649796160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAMS ALBERTO PARRA MONTANO

Provider Business Mailing Address
First Line	:	321 TO TO LO CHEE DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5239
Country	:	US
Telephone Number	:	305-951-4957
Fax Number	:	305-901-1797

Provider Business Practice Location Address
First Line	:	2258 W 74TH ST APT 101
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-6848
Country	:	US
Telephone Number	:	786-346-9934
Fax Number	:	305-901-1797

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

Provider Enumeration Date	:	08/16/2017
Last Update Date	:	08/16/2017

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