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NPI Code Detail

MEDICARE: MR. ALEXIS ALI MIRELES

MEDICARE: MR. ALEXIS ALI MIRELES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianTX

General Provider Information

NPI Number : 1407701824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALEXIS ALI MIRELES
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 877-610-0580
Fax Number : 866-611-1558
Provider Business Practice Location Address
First Line : 2424 VILLAGE DR
Second Line :
City : BROWNSVILLE
State : TX
Zip : 78521-1480
Country : US
Telephone Number : 956-431-0056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ MR. ALEXIS ALI MIRELES ” Practice Location

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