Provider Demographics
NPI:1376428425
Name:ARTILES PAULKE, ANTONIO JESUS
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:JESUS
Last Name:ARTILES PAULKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4345 E 8TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2415
Mailing Address - Country:US
Mailing Address - Phone:561-947-0281
Mailing Address - Fax:
Practice Address - Street 1:4345 E 8TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2415
Practice Address - Country:US
Practice Address - Phone:561-947-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA634010004610106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician