Provider Demographics
NPI:1154021871
Name:ALVAREZ GUTIERREZ, YOAN MANUEL (RBT)
Entity type:Individual
Prefix:MR
First Name:YOAN
Middle Name:MANUEL
Last Name:ALVAREZ GUTIERREZ
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2996 NW 87TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-3756
Mailing Address - Country:US
Mailing Address - Phone:786-439-7704
Mailing Address - Fax:
Practice Address - Street 1:2996 NW 87TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-3756
Practice Address - Country:US
Practice Address - Phone:786-439-7704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2024-02-05
Deactivation Date:2023-04-07
Deactivation Code:
Reactivation Date:2024-02-05
Provider Licenses
StateLicense IDTaxonomies
FLBACB905101106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician