Individual
ADALEIDY FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
807 BUCK ST, HALLANDALE BEACH, FL 33009-6154
(786) 534-7172
Mailing address
807 BUCK ST, HALLANDALE BEACH, FL 33009-6154
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-214793
FL
Other
Enumeration date
06/27/2023
Last updated
07/10/2023
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