Provider Demographics
NPI:1568269611
Name:ALFONSO SANTO, RAYSA
Entity type:Individual
Prefix:
First Name:RAYSA
Middle Name:
Last Name:ALFONSO SANTO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6253 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1113
Mailing Address - Country:US
Mailing Address - Phone:786-670-4708
Mailing Address - Fax:
Practice Address - Street 1:6253 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1113
Practice Address - Country:US
Practice Address - Phone:786-670-4708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician