Provider Demographics
NPI:1992386064
Name:ALPHACARE CLINICS LLC
Entity Type:Organization
Organization Name:ALPHACARE CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUDGER
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIACIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-462-6856
Mailing Address - Street 1:10526 WHEELHOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1214
Mailing Address - Country:US
Mailing Address - Phone:516-462-6856
Mailing Address - Fax:855-727-7299
Practice Address - Street 1:10526 WHEELHOUSE CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1214
Practice Address - Country:US
Practice Address - Phone:516-462-6856
Practice Address - Fax:855-727-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty