Healthcare Provider Details

I. General information

NPI: 1831644830
Provider Name (Legal Business Name): MARIA ALEJANDRA MIDDLETON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11841 HERMITAGE DR
PLANTATION FL
33325-3511
US

IV. Provider business mailing address

11841 HERMITAGE DR
PLANTATION FL
33325-3511
US

V. Phone/Fax

Practice location:
  • Phone: 754-300-0284
  • Fax:
Mailing address:
  • Phone: 754-300-0284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-71539
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: