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NPI Code Detail

MEDICARE: LIS ESPINOSA ALFONSO

MEDICARE: LIS ESPINOSA ALFONSO
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1891557799
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIS ESPINOSA ALFONSO
Provider Business Mailing Address
First Line : 41 E 60TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33013-1059
Country : US
Telephone Number : 305-491-9740
Fax Number :
Provider Business Practice Location Address
First Line : 1486 W 84TH ST
Second Line :
City : HIALEAH
State : FL
Zip : 33014-3363
Country : US
Telephone Number : 305-828-5276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2024
Last Update Date : 01/25/2024

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Directions to “ LIS ESPINOSA ALFONSO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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