Individual
ALFONSO ISMAEL LEY COSSIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11591 SW 10TH ST, PEMBROKE PINES, FL 33025-4326
(786) 326-7571
Mailing address
11591 SW 10TH ST, PEMBROKE PINES, FL 33025-4326
(786) 326-7571
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-258665
FL
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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