Provider Demographics
NPI:1609000678
Name:ALAY, ANTONIO A
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:A
Last Name:ALAY
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 1:13500 SW 1ST ST
Mailing Address - Street 2:NEW HAMPTON U212
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1618
Mailing Address - Country:US
Mailing Address - Phone:954-324-5989
Mailing Address - Fax:954-441-7856
Practice Address - Street 1:594 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7615
Practice Address - Country:US
Practice Address - Phone:954-344-6550
Practice Address - Fax:954-344-8634
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst