MEDICARE: ALCASIAS CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1316422462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALCASIAS CORP

Provider Business Mailing Address
First Line	:	2719 HOLLYWOOD BLVD STE A-1512
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4821
Country	:	US
Telephone Number	:	754-232-3102
Fax Number	:

Provider Business Practice Location Address
First Line	:	2719 HOLLYWOOD BLVD STE A-1512
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-4821
Country	:	US
Telephone Number	:	754-232-3102
Fax Number	:	754-263-5895

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HUSTON USRY JR.
Credential	:
Telephone Number	:	754-232-3102

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	09/25/2018

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Directions to “ALCASIAS CORP ” Practice Location

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