Provider Demographics
NPI:1720467178
Name:MESA BARRERA, ALINA
Entity Type:Individual
Prefix:MISS
First Name:ALINA
Middle Name:
Last Name:MESA BARRERA
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 1:935 W 23RD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-2039
Mailing Address - Country:US
Mailing Address - Phone:305-316-1460
Mailing Address - Fax:
Practice Address - Street 1:935 W 23RD ST APT 3
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2039
Practice Address - Country:US
Practice Address - Phone:305-316-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014766400Medicaid