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General NPI Number Information
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NPI Number | 1992386064
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Entity Type | Organization
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Legal Business Name | ALPHACARE CLINICS LLC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 06/05/2021
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Provider Practice Location Address
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Address Line | 10526 WHEELHOUSE CIR
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City | BOCA RATON
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State | FL
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Zip | 33428-1214
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Country | US
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Telephone | 516-462-6856
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Fax | 855-727-7299
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Provider Business Mailing Address
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Address Line | 10526 WHEELHOUSE CIR
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City | BOCA RATON
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State | FL
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Zip | 33428-1214
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Country | US
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Telephone | 516-462-6856
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Fax | 855-727-7299
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUDGER ELIACIN
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Credential | DO
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Telephone | 516-462-6856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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