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NPI 1225551179

NPI 1225551179 : ALANIS BORREGO : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1225551179
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    Entity Type          |    Individual 
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    Provider Name        |    ALANIS BORREGO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/24/2017
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    Last Update Date     |    07/24/2017
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Provider Practice Location Address
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    Address Line         |    11025 SW 84TH ST STE 8 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33173-3856
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    Country              |    US
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    Telephone            |    305-971-1230
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    Fax                  |    305-971-3095
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Provider Business Mailing Address
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    Address Line         |    8920 SW 41ST TER 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33165-5316
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    Country              |    US
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    Telephone            |    305-496-1637
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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