Provider Demographics
NPI:1750445391
Name:ALONSO, ALINA T (RN,BCBA,APRN)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:T
Last Name:ALONSO
Suffix:
Gender:F
Credentials:RN,BCBA,APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 SE 46TH ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-7435
Mailing Address - Country:US
Mailing Address - Phone:305-978-9075
Mailing Address - Fax:888-900-9193
Practice Address - Street 1:1625 SE 46TH ST STE 3B
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7435
Practice Address - Country:US
Practice Address - Phone:305-978-9075
Practice Address - Fax:888-900-9193
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9224997163W00000X
FLF06220442363LF0000X
FL1-21-55877103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1-21-55877OtherBCBA