Healthcare Provider Details

I. General information

NPI: 1306472899
Provider Name (Legal Business Name): ALEXANDRA MAYRE ARELLANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 MAITLAND AVE
ALTAMONTE SPRINGS FL
32701-4914
US

IV. Provider business mailing address

12019 MOCCASIN CT
ORLANDO FL
32828-8976
US

V. Phone/Fax

Practice location:
  • Phone: 407-476-6357
  • Fax:
Mailing address:
  • Phone: 786-303-0379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH19002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: