Provider Demographics
NPI:1386267920
Name:SANZ, ALEJANDRO
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:SANZ
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 1:39 W 27TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1740
Mailing Address - Country:US
Mailing Address - Phone:786-277-1745
Mailing Address - Fax:
Practice Address - Street 1:27501 S DIXIE HWY STE 200
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8219
Practice Address - Country:US
Practice Address - Phone:786-601-2608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-117229106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician