Provider Demographics
NPI:1477377653
Name:PUEBLA MOREJON, ALINA M
Entity type:Individual
Prefix:
First Name:ALINA
Middle Name:M
Last Name:PUEBLA MOREJON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15607 NW 37TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6349
Mailing Address - Country:US
Mailing Address - Phone:305-922-9457
Mailing Address - Fax:
Practice Address - Street 1:8040 NW 95TH ST STE 337
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33016-2361
Practice Address - Country:US
Practice Address - Phone:954-793-0775
Practice Address - Fax:786-641-5968
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty