Individual
ALFREDO SEGUNDO GRANADO ROBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6616 N CHURCH AVE APT D, TAMPA, FL 33614-3976
(813) 576-9120
Mailing address
301 ROBERT AVE, LEHIGH ACRES, FL 33936-1623
(502) 379-7457
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/16/2023
Last updated
01/11/2024
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