Individual
ALEXIS VALENTIN CALDERON DISOTUAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18511 SW 200TH ST, MIAMI, FL 33187-2503
(786) 333-0232
Mailing address
18511 SW 200TH ST, MIAMI, FL 33187-2503
(786) 333-0232
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-124059
FL
Other
Enumeration date
12/22/2020
Last updated
12/11/2024
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