Provider Demographics
NPI:1023604428
Name:ALBERTO DUENAS, ALEJANDRA MARIA
Entity type:Individual
Prefix:MS
First Name:ALEJANDRA
Middle Name:MARIA
Last Name:ALBERTO DUENAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11940 SW 185TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3215
Mailing Address - Country:US
Mailing Address - Phone:786-779-9899
Mailing Address - Fax:
Practice Address - Street 1:11940 SW 185TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-3215
Practice Address - Country:US
Practice Address - Phone:786-779-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-127433106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician