Provider Demographics
NPI:1093324303
Name:ALONSO, ARIESKYS J
Entity Type:Individual
Prefix:
First Name:ARIESKYS
Middle Name:J
Last Name:ALONSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 SW 87TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5472
Mailing Address - Country:US
Mailing Address - Phone:786-615-4443
Mailing Address - Fax:786-391-0676
Practice Address - Street 1:3850 SW 87TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5472
Practice Address - Country:US
Practice Address - Phone:786-615-4443
Practice Address - Fax:786-391-0676
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker