Provider Demographics
NPI:1326912940
Name:FLORES-TUNDIDOR, ALEJANDRO JOSE
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:JOSE
Last Name:FLORES-TUNDIDOR
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 1:7040 NW 177TH ST APT 101
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6278
Mailing Address - Country:US
Mailing Address - Phone:786-483-0166
Mailing Address - Fax:
Practice Address - Street 1:2000 NW 150TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2870
Practice Address - Country:US
Practice Address - Phone:786-264-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician