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Individual

ALEXIS MARTINEZ GRILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8866 W FLAGLER ST APT 205, MIAMI, FL 33174-3944
(786) 521-9745
Mailing address
8866 W FLAGLER ST APT 205, MIAMI, FL 33174-3944
(786) 521-9745

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BCBA1-22-60126
FL
106S00000X
Behavior Technician
RBT20116305
FL
224Z00000X
Occupational Therapy Assistant
OTA13870
FL

Other

Enumeration date
09/15/2014
Last updated
08/19/2022
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