Healthcare Provider Details

I. General information

NPI: 1376330282
Provider Name (Legal Business Name): ELENA MARGARITA ALCAZAR FLINT
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: ELENA MARGARITA ALCAZAR ZANONI

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S SEMORAN BLVD STE A
ORLANDO FL
32807-1424
US

IV. Provider business mailing address

820 SENECA MEADOWS RD
WINTER SPRINGS FL
32708-4741
US

V. Phone/Fax

Practice location:
  • Phone: 407-704-7811
  • Fax: 407-382-0659
Mailing address:
  • Phone: 786-653-2616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: