Provider Demographics
NPI:1366318727
Name:LOVERA, DAVID ALEJANDRO
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALEJANDRO
Last Name:LOVERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2985 BOSQUE AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4421
Mailing Address - Country:US
Mailing Address - Phone:305-491-1481
Mailing Address - Fax:
Practice Address - Street 1:2985 BOSQUE AVE APT 102
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4421
Practice Address - Country:US
Practice Address - Phone:305-491-1481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL233466796000106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty