Healthcare Provider Details

I. General information

NPI: 1689504367
Provider Name (Legal Business Name): AVANAIZA MASSIEL ALCINDOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2437 SE 17TH ST STE 102
OCALA FL
34471-9104
US

IV. Provider business mailing address

2225 SW 146TH LOOP
OCALA FL
34473-7536
US

V. Phone/Fax

Practice location:
  • Phone: 352-509-5210
  • Fax:
Mailing address:
  • Phone: 352-789-2254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: