Provider Demographics
NPI:1386276681
Name:ESPINOSA, ANTHONY ALEJANDRO (BCBA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ALEJANDRO
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 W 80TH ST UNIT 102
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7501
Mailing Address - Country:US
Mailing Address - Phone:305-336-7499
Mailing Address - Fax:
Practice Address - Street 1:3502 W 80TH ST UNIT 102
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-7501
Practice Address - Country:US
Practice Address - Phone:305-336-7499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FL1-24-72427103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician