Individual
LETICIA ALONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13155 SW 134TH ST STE 115, MIAMI, FL 33186-4487
(786) 429-3738
(305) 397-2416
Mailing address
13155 SW 134TH ST STE 115, MIAMI, FL 33186-4487
(786) 429-3738
(305) 397-2416
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
FL
106S00000X
Behavior Technician
—
—
374U00000X
Home Health Aide
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003015700
MEDICAID WAIVER
FL
05
—
005564800
—
FL
01
—
017450000
BEHAVIOR ANALYSIST GROUP
FL
01
—
1961538
WELLCARE
FL
Enumeration date
06/28/2016
Last updated
04/05/2022
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