Provider Demographics
NPI:1881558468
Name:ALONSO GARCIA, LYES LENAY
Entity type:Individual
Prefix:
First Name:LYES
Middle Name:LENAY
Last Name:ALONSO GARCIA
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 1:6765 W 2ND CT APT 204
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6738
Mailing Address - Country:US
Mailing Address - Phone:786-695-2062
Mailing Address - Fax:
Practice Address - Street 1:6765 W 2ND CT APT 204
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6738
Practice Address - Country:US
Practice Address - Phone:786-695-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-09
Last Update Date:2025-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA614-726-82-300-0106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty