Provider Demographics
NPI:1740047257
Name:AGRAMONTE SALGADO, ALEJANDRO LAZARO
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:LAZARO
Last Name:AGRAMONTE SALGADO
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 1:206 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6011
Mailing Address - Country:US
Mailing Address - Phone:786-387-3520
Mailing Address - Fax:
Practice Address - Street 1:206 W LAKE DR
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6011
Practice Address - Country:US
Practice Address - Phone:786-387-3520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician