Provider Demographics
NPI:1134949209
Name:ARIOSA, LUIS ALFREDO
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:ALFREDO
Last Name:ARIOSA
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 1:643 EXECUTIVE CENTER DR APT Q207
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-4931
Mailing Address - Country:US
Mailing Address - Phone:561-895-3977
Mailing Address - Fax:
Practice Address - Street 1:643 EXECUTIVE CENTER DR APT Q207
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4931
Practice Address - Country:US
Practice Address - Phone:561-895-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician