Provider Demographics
NPI:1407192826
Name:ALTERNATIVE HEALTH CONCEPTS OF FLORIDA
Entity Type:Organization
Organization Name:ALTERNATIVE HEALTH CONCEPTS OF FLORIDA
Other - Org Name:THE CAPORALE CENTER OF NATURAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK-CAPORALE
Authorized Official - Suffix:
Authorized Official - Credentials:AP, DOM
Authorized Official - Phone:727-521-0210
Mailing Address - Street 1:111 2ND AVE NE
Mailing Address - Street 2:SUITE 511
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3434
Mailing Address - Country:US
Mailing Address - Phone:727-521-0210
Mailing Address - Fax:727-521-0211
Practice Address - Street 1:111 2ND AVE NE
Practice Address - Street 2:SUITE 511
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3434
Practice Address - Country:US
Practice Address - Phone:727-521-0210
Practice Address - Fax:727-521-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1348261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center