1689006371 NPI number — VALERIE A ALFERA SLP/CCC

Table of content: VALERIE A ALFERA SLP/CCC (NPI 1689006371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689006371 NPI number — VALERIE A ALFERA SLP/CCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALFERA
Provider First Name:
VALERIE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP/CCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689006371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8616 SW CRUDEN BAY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34997-4206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-685-6129
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
169 TEQUESTA DR
Provider Second Line Business Practice Location Address:
SUITE 24E
Provider Business Practice Location Address City Name:
TEQUESTA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33469-2768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-747-8188
Provider Business Practice Location Address Fax Number:
561-747-8388
Provider Enumeration Date:
08/05/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SA 1582 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001691601 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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