Healthcare Provider Details

I. General information

NPI: 1134803083
Provider Name (Legal Business Name): JANELL ILEANA ALZATE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11025 SW 84TH ST STE 7
MIAMI FL
33173-3856
US

IV. Provider business mailing address

11610 SW 123RD AVE
MIAMI FL
33186-5045
US

V. Phone/Fax

Practice location:
  • Phone: 305-279-4141
  • Fax:
Mailing address:
  • Phone: 305-528-7704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License NumberSZ12709
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ12709
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: