Provider Demographics
NPI:1871211540
Name:LARA ALVARADO, ALEJANDRINA (RBT)
Entity type:Individual
Prefix:MS
First Name:ALEJANDRINA
Middle Name:
Last Name:LARA ALVARADO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9905 DEAN ACRE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6559
Mailing Address - Country:US
Mailing Address - Phone:786-803-0752
Mailing Address - Fax:
Practice Address - Street 1:9905 DEAN ACRE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-6559
Practice Address - Country:US
Practice Address - Phone:786-803-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22212234106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician