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General NPI Number Information
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NPI Number | 1427748615
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Entity Type | Individual
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Provider Name | ALEXIS MIA ALVAREZ
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Gender | Female
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Dates
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Enumeration Date | 05/10/2023
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Last Update Date | 05/10/2023
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Provider Practice Location Address
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Address Line | 701 PROMENADE DR STE 250
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-6035
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Country | US
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Telephone | 954-399-2637
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Fax |
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Provider Business Mailing Address
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Address Line | 2745 NW 208 TERRACE MIAMI GARDENS 33056
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City | MIAMI GARDENS
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State | FL
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Zip | 33056
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Country | US
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Telephone | 786-385-8661
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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