=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992984769
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALTERNATIVE INTEGRATED HEALTH OPTIONS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2007
-----------------------------------------------------
Last Update Date | 03/15/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2155 NE MIAMI GARDENS DR
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-5051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 788-436-7122
-----------------------------------------------------
Fax | 305-937-2361
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2155 NE MIAMI GARDENS DR
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33179-5051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 788-436-7122
-----------------------------------------------------
Fax | 305-937-2361
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MARLENE CESAR
-----------------------------------------------------
Credential | ARNP
-----------------------------------------------------
Telephone | 786-436-7122
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | ARNP3085972
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------