Provider Demographics
NPI:1558199620
Name:INFANTE, ALICIA (RBT)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:INFANTE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15078 SW 104TH ST
Mailing Address - Street 2:APT 909
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-3276
Mailing Address - Country:US
Mailing Address - Phone:786-450-3580
Mailing Address - Fax:
Practice Address - Street 1:11402 NW 41ST ST # 206
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4859
Practice Address - Country:US
Practice Address - Phone:305-373-3424
Practice Address - Fax:305-373-3474
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-363555106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician