Provider Demographics
NPI:1588464754
Name:DUSSAN, HELBERT ALEXANDER SR
Entity type:Individual
Prefix:MR
First Name:HELBERT
Middle Name:ALEXANDER
Last Name:DUSSAN
Suffix:SR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12139 SW 11TH CT UNIT 57
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5733
Mailing Address - Country:US
Mailing Address - Phone:754-267-0474
Mailing Address - Fax:
Practice Address - Street 1:12139 SW 11TH CT UNIT 57
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-5733
Practice Address - Country:US
Practice Address - Phone:754-267-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician