=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750445391
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALINA T ALONSO APRN, BCBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 06/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1625 SE 46TH ST STE 3B
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33904-7435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-978-9075
-----------------------------------------------------
Fax | 888-900-9193
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1625 SE 46TH ST STE 3B
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33904-7435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-978-9075
-----------------------------------------------------
Fax | 888-900-9193
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 1-21-55877
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 9224997
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------