Healthcare Provider Details

I. General information

NPI: 1740695584
Provider Name (Legal Business Name): IZZA MARIE ALCAIDE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 NE 14TH ST APT 1008
MIAMI FL
33132-1601
US

IV. Provider business mailing address

245 NE 14TH ST APT 1008
MIAMI FL
33132-1614
US

V. Phone/Fax

Practice location:
  • Phone: 305-815-1888
  • Fax:
Mailing address:
  • Phone: 305-815-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH12498
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: