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General NPI Number Information
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NPI Number | 1750958740
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Entity Type | Individual
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Provider Name | ALFREDO MUNOZ HERNANDEZ
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Gender | Male
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 30342 SW 163RD AVE
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City | HOMESTEAD
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State | FL
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Zip | 33033-3302
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Country | US
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Telephone | 239-240-1217
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Fax |
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Provider Business Mailing Address
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Address Line | 30342 SW 163RD AVE
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City | HOMESTEAD
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State | FL
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Zip | 33033-3302
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Country | US
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Telephone | 239-240-1217
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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 | 20-133536
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License Number State | FL
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