Provider Demographics
NPI:1316573108
Name:VILLASUSO, ALCESTE
Entity Type:Individual
Prefix:
First Name:ALCESTE
Middle Name:
Last Name:VILLASUSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALCESTE
Other - Middle Name:
Other - Last Name:LAURENTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:951 BRICKELL AVE APT 710
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3933
Mailing Address - Country:US
Mailing Address - Phone:727-412-4903
Mailing Address - Fax:
Practice Address - Street 1:3501 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5421
Practice Address - Country:US
Practice Address - Phone:727-412-4903
Practice Address - Fax:954-985-1434
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005301363LP0200X
FLARNP110053012080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics