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General NPI Number Information
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NPI Number | 1487213211
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Entity Type | Individual
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Provider Name | ALELY HOSTIA OD
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Gender | Female
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 3931 S GILBERT RD
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City | GILBERT
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State | AZ
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Zip | 85297-2004
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Country | US
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Telephone | 480-281-0204
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Fax |
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Provider Business Mailing Address
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Address Line | 400 E EARLL DR UNIT 311
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City | PHOENIX
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State | AZ
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Zip | 85012-0022
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Country | US
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Telephone | 813-506-2360
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5656
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License Number State | FL
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