Provider Demographics
NPI:1255838389
Name:ALSINA TRIAY, MARIA D (BCBA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:ALSINA TRIAY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8159 W 36TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1836
Mailing Address - Country:US
Mailing Address - Phone:786-803-2323
Mailing Address - Fax:
Practice Address - Street 1:3273 W 14TH LN
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4717
Practice Address - Country:US
Practice Address - Phone:786-803-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-18-9333106E00000X
FL1-20-44599103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020991600Medicaid