Healthcare Provider Details

I. General information

NPI: 1316573108
Provider Name (Legal Business Name): ALCESTE VILLASUSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALCESTE LAURENTI DNP

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 JOHNSON ST
HOLLYWOOD FL
33021-5421
US

IV. Provider business mailing address

951 BRICKELL AVE APT 710
MIAMI FL
33131-3933
US

V. Phone/Fax

Practice location:
  • Phone: 727-412-4903
  • Fax: 954-985-1434
Mailing address:
  • Phone: 727-412-4903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11005301
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberARNP11005301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: