Provider Demographics
NPI:1093428161
Name:FERNANDEZ VALDES, ALINA SOLEDAD (RBT)
Entity Type:Individual
Prefix:MISS
First Name:ALINA
Middle Name:SOLEDAD
Last Name:FERNANDEZ VALDES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 GLEN ROYAL PKWY APT 5
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-5253
Mailing Address - Country:US
Mailing Address - Phone:305-457-6940
Mailing Address - Fax:
Practice Address - Street 1:67 GLEN ROYAL PKWY APT 5
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-5253
Practice Address - Country:US
Practice Address - Phone:305-457-6940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-146582106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty