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General NPI Number Information
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NPI Number | 1649080607
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Entity Type | Individual
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Provider Name | ASHLEY MARYANN ALONSO
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Gender | Female
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Dates
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Enumeration Date | 01/11/2025
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Last Update Date | 01/11/2025
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Provider Practice Location Address
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Address Line | 5201 BLUE LAGOON DR STE 900
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City | MIAMI
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State | FL
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Zip | 33126-7057
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Country | US
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Telephone | 305-310-1624
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Fax |
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Provider Business Mailing Address
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Address Line | 6931 MIAMI LAKEWAY S
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2925
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Country | US
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Telephone | 305-298-5113
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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 | A452013035660
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License Number State | FL
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