Healthcare Provider Details

I. General information

NPI: 1760989099
Provider Name (Legal Business Name): CYNDIA TALIA ALFONSO RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7290 SW 90TH ST APT 302
MIAMI FL
33156
US

IV. Provider business mailing address

9045 SW 160TH TER
PALMETTO BAY FL
33157-3596
US

V. Phone/Fax

Practice location:
  • Phone: 786-678-5051
  • Fax:
Mailing address:
  • Phone: 786-678-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-49532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: