Provider Demographics
NPI:1275049124
Name:ALONSO REYES, ROSARIO DEL CARMEN
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:DEL CARMEN
Last Name:ALONSO REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9902 HAMMOCKS BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1571
Mailing Address - Country:US
Mailing Address - Phone:786-527-0442
Mailing Address - Fax:
Practice Address - Street 1:9902 HAMMOCKS BLVD APT 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1571
Practice Address - Country:US
Practice Address - Phone:786-527-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician