Provider Demographics
NPI: | 1225434475 |
---|---|
Name: | YGLESIAS ALCARAZO, ERNESTO (ARNP,NP-C) |
Entity type: | Individual |
Prefix: | |
First Name: | ERNESTO |
Middle Name: | |
Last Name: | YGLESIAS ALCARAZO |
Suffix: | |
Gender: | M |
Credentials: | ARNP,NP-C |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 13804 SW 26TH TER |
Mailing Address - Street 2: | |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33175-6576 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 786-227-4785 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2711 SW 137TH AVE STE 93 |
Practice Address - Street 2: | |
Practice Address - City: | MIAMI |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33175-6361 |
Practice Address - Country: | US |
Practice Address - Phone: | 786-227-4785 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2014-11-17 |
Last Update Date: | 2025-06-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | AR9292665 | 363LF0000X |
FL | BCBA1-20-42794 | 103K00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | ARNP9292665 | Other | ARNP |
FL | 103337400 | Medicaid |