Provider Demographics
NPI:1922984285
Name:MONTERO ALVAREZ, TATIANA
Entity type:Individual
Prefix:
First Name:TATIANA
Middle Name:
Last Name:MONTERO ALVAREZ
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 1:2424 GOOD WILL ALY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-6172
Mailing Address - Country:US
Mailing Address - Phone:407-485-5902
Mailing Address - Fax:
Practice Address - Street 1:3501 W VINE ST STE 104B
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4644
Practice Address - Country:US
Practice Address - Phone:407-967-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-25-458222106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician