Provider Demographics
NPI:1942746821
Name:ALVAREZ, AIDA
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:
Last Name:ALVAREZ
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 1:71 W 22ND ST
Mailing Address - Street 2:#2
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2295
Mailing Address - Country:US
Mailing Address - Phone:305-321-4388
Mailing Address - Fax:
Practice Address - Street 1:71 W 22ND ST
Practice Address - Street 2:#2
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2295
Practice Address - Country:US
Practice Address - Phone:305-321-4388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst