Provider Demographics
NPI:1386374858
Name:MESTRIL ALARCON, MISSDERLY
Entity type:Individual
Prefix:
First Name:MISSDERLY
Middle Name:
Last Name:MESTRIL ALARCON
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 1:13586 NORTHUMBERLAND CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8930
Mailing Address - Country:US
Mailing Address - Phone:561-270-9470
Mailing Address - Fax:
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD STE 300M
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6515
Practice Address - Country:US
Practice Address - Phone:561-788-4086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician