Provider Demographics
NPI:1437645660
Name:LANDRON-ROMERO, ALFREDO J (BEHAVIORAL ANALYST)
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:J
Last Name:LANDRON-ROMERO
Suffix:
Gender:M
Credentials:BEHAVIORAL ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5180 W ATLANTIC AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8103
Mailing Address - Country:US
Mailing Address - Phone:561-674-9996
Mailing Address - Fax:561-200-5192
Practice Address - Street 1:5180 W ATLANTIC AVE STE 114
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8103
Practice Address - Country:US
Practice Address - Phone:561-674-9996
Practice Address - Fax:561-200-5192
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-18-31343103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022206500Medicaid