Healthcare Provider Details

I. General information

NPI: 1134066525
Provider Name (Legal Business Name): YELEINNIS ALCORTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4385 W 16TH AVE
HIALEAH FL
33012-7628
US

IV. Provider business mailing address

4385 W 16TH AVE
HIALEAH FL
33012-7628
US

V. Phone/Fax

Practice location:
  • Phone: 305-824-0637
  • Fax:
Mailing address:
  • Phone: 305-824-0637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCBHCMS0102883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: