Provider Demographics
NPI:1891519435
Name:ALONSO OLAZABAL, ORLANDO M
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:M
Last Name:ALONSO OLAZABAL
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 1:2507 NW 16TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1259
Mailing Address - Country:US
Mailing Address - Phone:786-694-1827
Mailing Address - Fax:
Practice Address - Street 1:2507 NW 16TH STREET RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1259
Practice Address - Country:US
Practice Address - Phone:786-694-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician