Provider Demographics
NPI:1508286568
Name:ALVAREZ TRUEBA, MELBA ANA (MH)
Entity Type:Individual
Prefix:MS
First Name:MELBA
Middle Name:ANA
Last Name:ALVAREZ TRUEBA
Suffix:
Gender:F
Credentials:MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8999 SW 123RD CT
Mailing Address - Street 2:APT 108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4168
Mailing Address - Country:US
Mailing Address - Phone:786-234-9053
Mailing Address - Fax:
Practice Address - Street 1:8999 SW 123RD CT
Practice Address - Street 2:APT 108
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186
Practice Address - Country:US
Practice Address - Phone:786-234-9053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14484101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018955400Medicaid