Healthcare Provider Details

I. General information

NPI: 1821637372
Provider Name (Legal Business Name): JOHN ALAIMO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 MARINER BLVD
SPRING HILL FL
34609-5691
US

IV. Provider business mailing address

10014 N DALE MABRY HWY STE C-100
TAMPA FL
33618-4426
US

V. Phone/Fax

Practice location:
  • Phone: 800-356-4049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-111073
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: