Provider Demographics
NPI:1962231878
Name:ANESTO, ALAIN
Entity type:Individual
Prefix:
First Name:ALAIN
Middle Name:
Last Name:ANESTO
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 1:850 W 49TH ST APT 803
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3552
Mailing Address - Country:US
Mailing Address - Phone:786-792-8723
Mailing Address - Fax:
Practice Address - Street 1:850 W 49TH ST APT 803
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3552
Practice Address - Country:US
Practice Address - Phone:786-792-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034232363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily