MEDICARE: YUSLEYVIS ALONSO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RB-20-123258	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104596477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUSLEYVIS ALONSO

Provider Business Mailing Address
First Line	:	1982 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-2714
Country	:	US
Telephone Number	:	786-409-3231
Fax Number	:	786-409-3273

Provider Business Practice Location Address
First Line	:	1982 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-2714
Country	:	US
Telephone Number	:	786-409-3231
Fax Number	:	786-409-3273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	03/12/2026

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Directions to “ YUSLEYVIS ALONSO ” Practice Location

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