Provider Demographics
NPI:1386346195
Name:PADRON, ALAIN JESUS
Entity type:Individual
Prefix:
First Name:ALAIN
Middle Name:JESUS
Last Name:PADRON
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 1:750 NW 43RD AVE APT 608
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3557
Mailing Address - Country:US
Mailing Address - Phone:786-757-9776
Mailing Address - Fax:
Practice Address - Street 1:750 NW 43RD AVE APT 608
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3557
Practice Address - Country:US
Practice Address - Phone:786-757-9776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB624948106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician