Provider Demographics
NPI:1235779091
Name:CARDESO, ALEJANDRA (MS,ED-BCBA)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:CARDESO
Suffix:
Gender:F
Credentials:MS,ED-BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14263 SW 180TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2641
Mailing Address - Country:US
Mailing Address - Phone:786-306-3674
Mailing Address - Fax:
Practice Address - Street 1:13500 SW 88TH ST UNIT 285
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1515
Practice Address - Country:US
Practice Address - Phone:786-409-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-20-11274106E00000X
FLRBT-19-89084106S00000X
FL1-21-56385103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician