Healthcare Provider Details

I. General information

NPI: 1972380772
Provider Name (Legal Business Name): MAURICIO ALFONSO PICHIN FRANCO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17221 NW 94TH CT APT 307
HIALEAH FL
33018-4362
US

IV. Provider business mailing address

17221 NW 94TH CT APT 307
HIALEAH FL
33018-4362
US

V. Phone/Fax

Practice location:
  • Phone: 786-919-3084
  • Fax:
Mailing address:
  • Phone: 786-919-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2849626
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-296770
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: