Individual
ALICIA MENA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2722 SW 28TH AVE, MIAMI, FL 33133-3031
(786) 315-7578
Mailing address
2722 SW 28TH AVE, MIAMI, FL 33133-3031
(786) 315-7578
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-259570
FL
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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