Provider Demographics
NPI:1699360248
Name:UGARDE, ALEXANDER (BCABA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:UGARDE
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 PONCE DE LEON BLVD STE 64
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2435
Mailing Address - Country:US
Mailing Address - Phone:305-397-8679
Mailing Address - Fax:833-817-6434
Practice Address - Street 1:5915 PONCE DE LEON BLVD STE 64
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2435
Practice Address - Country:US
Practice Address - Phone:305-397-8679
Practice Address - Fax:833-817-6434
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-157625106S00000X
FL0-23-14436106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT21157625OtherBACB