Provider Demographics
NPI:1508824574
Name:ALLIETE ALFANO, SLP, P.A.
Entity Type:Organization
Organization Name:ALLIETE ALFANO, SLP, P.A.
Other - Org Name:THE ALFANO CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLIETE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CCC-SLP
Authorized Official - Phone:305-461-4702
Mailing Address - Street 1:4960 SW 72ND AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5549
Mailing Address - Country:US
Mailing Address - Phone:305-461-4702
Mailing Address - Fax:305-461-4705
Practice Address - Street 1:4960 SW 72ND AVE STE 210
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5549
Practice Address - Country:US
Practice Address - Phone:305-461-4702
Practice Address - Fax:305-461-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5335235Z00000X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890596700Medicaid