Provider Demographics
NPI:1912696386
Name:FIS ALVAREZ, ZOELYS
Entity Type:Individual
Prefix:
First Name:ZOELYS
Middle Name:
Last Name:FIS ALVAREZ
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 1:8875 SW 214TH ST
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-3779
Mailing Address - Country:US
Mailing Address - Phone:786-479-9216
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 36TH ST STE 416
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6686
Practice Address - Country:US
Practice Address - Phone:786-817-4129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-253011106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician