Provider Demographics
NPI:1962969196
Name:CEPERO ALARCON, ELENA ROSA
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:ROSA
Last Name:CEPERO 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 1:3023 NW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1921
Mailing Address - Country:US
Mailing Address - Phone:866-208-0647
Mailing Address - Fax:
Practice Address - Street 1:459 NW 132ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33182-1629
Practice Address - Country:US
Practice Address - Phone:305-898-4162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care