Provider Demographics
NPI:1598655631
Name:GOVIN ALONSO, MARLON ABEL
Entity type:Individual
Prefix:
First Name:MARLON
Middle Name:ABEL
Last Name:GOVIN ALONSO
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 1:6205 SW KENDALE LAKES CIR APT 288
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1947
Mailing Address - Country:US
Mailing Address - Phone:754-243-1035
Mailing Address - Fax:
Practice Address - Street 1:6205 SW KENDALE LAKES CIR APT 288
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-1947
Practice Address - Country:US
Practice Address - Phone:754-243-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-435169106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician