Provider Demographics
NPI:1487213211
Name:HOSTIA, ALELY (OD)
Entity Type:Individual
Prefix:DR
First Name:ALELY
Middle Name:
Last Name:HOSTIA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E EARLL DR UNIT 311
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-0022
Mailing Address - Country:US
Mailing Address - Phone:813-506-2360
Mailing Address - Fax:
Practice Address - Street 1:3931 S GILBERT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-2004
Practice Address - Country:US
Practice Address - Phone:480-281-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5656152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist