Individual
AHMED ALFONSO TEBAS SACASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3350 SW 148TH AVE STE 110, MIRAMAR, FL 33027-3237
(786) 346-9021
Mailing address
7379 NW 173RD DR, HIALEAH, FL 33015-8484
(786) 909-1849
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-275161
FL
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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