Provider Demographics
NPI:1720560238
Name:CERNADAS, ALFONSO JR
Entity Type:Individual
Prefix:MR
First Name:ALFONSO
Middle Name:
Last Name:CERNADAS
Suffix:JR
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 1:3725 S OCEAN DR APT 907
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2910
Mailing Address - Country:US
Mailing Address - Phone:786-281-5827
Mailing Address - Fax:
Practice Address - Street 1:3725 S OCEAN DR APT 907
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2910
Practice Address - Country:US
Practice Address - Phone:786-281-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician