Individual
ALBERTO FUENTES DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13440 SW 178TH ST, MIAMI, FL 33177-7100
(786) 603-1019
Mailing address
13440 SW 178TH ST, MIAMI, FL 33177-7100
(786) 603-1019
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1074394
FL
Other
Enumeration date
10/19/2024
Last updated
10/19/2024
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