Provider Demographics
NPI:1962028373
Name:TIRADO, LOURDES ALVARADO
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:ALVARADO
Last Name:TIRADO
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 1:9952 SW 8TH ST APT 149
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2858
Mailing Address - Country:US
Mailing Address - Phone:786-738-3893
Mailing Address - Fax:
Practice Address - Street 1:9952 SW 8TH ST APT 149
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2858
Practice Address - Country:US
Practice Address - Phone:786-738-3893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT20118754103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst