MEDICARE: SHIRA MARTINEZ ALFARO BCABA

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	0-26-17212	FL

General Provider Information

NPI Number	:	1710753165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRA MARTINEZ ALFARO BCABA

Provider Business Mailing Address
First Line	:	10335 NW 127TH ST
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-6011
Country	:	US
Telephone Number	:	786-792-4720
Fax Number	:

Provider Business Practice Location Address
First Line	:	10335 NW 127TH ST
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-6011
Country	:	US
Telephone Number	:	786-792-4720
Fax Number	:

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

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	06/09/2026

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