Provider Demographics
NPI:1487238929
Name:CHACARTEGUI LAGARES, ALEJANDRO (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALEJANDRO
Middle Name:
Last Name:CHACARTEGUI LAGARES
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 HIGHLAND MANOR DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-9712
Mailing Address - Country:US
Mailing Address - Phone:813-344-2070
Mailing Address - Fax:
Practice Address - Street 1:10150 HIGHLAND MANOR DR STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9712
Practice Address - Country:US
Practice Address - Phone:813-344-2070
Practice Address - Fax:844-205-8756
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-16-23965103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111044200Medicaid