Healthcare Provider Details

I. General information

NPI: 1942967567
Provider Name (Legal Business Name): YALENNY BARBARA ALONSO FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 11/18/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SW 8TH ST STE 244
MIAMI FL
33144-4000
US

IV. Provider business mailing address

210 FONTAINEBLEAU BLVD APT 413
MIAMI FL
33172-4573
US

V. Phone/Fax

Practice location:
  • Phone: 305-909-4872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-183632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: