Provider Demographics
NPI:1396578936
Name:PRENDES DABLANCO, ALBERTO MIGUEL
Entity type:Individual
Prefix:
First Name:ALBERTO
Middle Name:MIGUEL
Last Name:PRENDES DABLANCO
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 1:28002 SW 134TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1952
Mailing Address - Country:US
Mailing Address - Phone:786-296-4986
Mailing Address - Fax:
Practice Address - Street 1:100 NE 15TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4581
Practice Address - Country:US
Practice Address - Phone:305-764-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-337188106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician