Provider Demographics
NPI:1427565290
Name:FEITO, AISMEL
Entity Type:Individual
Prefix:
First Name:AISMEL
Middle Name:
Last Name:FEITO
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 1:2985 NW 169TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-4317
Mailing Address - Country:US
Mailing Address - Phone:786-312-8707
Mailing Address - Fax:
Practice Address - Street 1:2985 NW 169TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-4317
Practice Address - Country:US
Practice Address - Phone:786-312-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician