Provider Demographics
NPI:1578060018
Name:ALFONSO FRANCES, MAYTE
Entity Type:Individual
Prefix:
First Name:MAYTE
Middle Name:
Last Name:ALFONSO FRANCES
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 1:740 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2354
Mailing Address - Country:US
Mailing Address - Phone:786-731-6536
Mailing Address - Fax:
Practice Address - Street 1:27501 S DIXIE HWY STE 200
Practice Address - Street 2:
Practice Address - City:NARANJA
Practice Address - State:FL
Practice Address - Zip Code:33032-8219
Practice Address - Country:US
Practice Address - Phone:786-601-2608
Practice Address - Fax:305-647-0250
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022457900Medicaid