Provider Demographics
NPI:1578773222
Name:IBARRA-ALOS, HELIA (MD)
Entity Type:Individual
Prefix:DR
First Name:HELIA
Middle Name:
Last Name:IBARRA-ALOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 PLAZA REAL STE 275
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3999
Mailing Address - Country:US
Mailing Address - Phone:561-944-0077
Mailing Address - Fax:
Practice Address - Street 1:1115 BROADWAY FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3454
Practice Address - Country:US
Practice Address - Phone:425-399-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME105183174400000X, 2084P0805X
MO20190004982084P0800X
NMTM2018-07142084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME105183OtherMEDICAL LIC.