MEDICARE: ALINTANA LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1487218426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALINTANA LLC

Provider Business Mailing Address
First Line	:	4410 MELTON AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7218
Country	:	US
Telephone Number	:	201-673-7575
Fax Number	:

Provider Business Practice Location Address
First Line	:	4410 MELTON AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7218
Country	:	US
Telephone Number	:	201-673-7575
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KARMELYN LEE
Credential	:	BCBA
Telephone Number	:	201-673-7575

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	04/25/2019

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Directions to “ALINTANA LLC ” Practice Location

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