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Provider Information for 1871029124

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

WARREN GOMEZ ALFONSO

Gender: MALE

Individual NPI: 1871029124

Calendar   Last Updated:  2017-05-05
  Certification Date: 

Details

Name Value
NPI 1871029124
Enumeration Date 2017-05-05
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 10487 SW 216TH ST APT 107
CUTLER BAY, FL 33190-1613
United States

Phone: 786-803-0875 | Fax:
View Map External Link
Primary Practice Address 10487 SW 216TH ST APT 107
CUTLER BAY, FL 33190-1613
United States

Phone: 786-803-0875 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 106S00000X - Behavior Technician