Provider Demographics
NPI:1730497850
Name:SARMIENTO, SERGIO ALONSO
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:ALONSO
Last Name:SARMIENTO
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 1:3565 FOREST HILL BLVD APT 91
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5890
Mailing Address - Country:US
Mailing Address - Phone:561-541-3684
Mailing Address - Fax:
Practice Address - Street 1:3565 FOREST HILL BLVD APT 91
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5890
Practice Address - Country:US
Practice Address - Phone:561-541-3684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst