MEDICARE: DR. HELIA IBARRA-ALOS MD

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	174400000X	Specialist	ME105183	FL
2	2084P0800X	Psychiatry Physician	2019000498	MO
3	2084P0800X	Psychiatry Physician	TM2018-0714	NM
4	2084P0805X	Geriatric Psychiatry Physician	ME105183	FL

General Provider Information

NPI Number	:	1578773222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELIA IBARRA-ALOS MD

Provider Business Mailing Address
First Line	:	950 PENINSULA CORPORATE CIR STE 1011
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-1384
Country	:	US
Telephone Number	:	561-944-0077
Fax Number	:	561-461-6152

Provider Business Practice Location Address
First Line	:	950 PENINSULA CORPORATE CIR STE 1011
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33487-1384
Country	:	US
Telephone Number	:	561-944-0077
Fax Number	:	561-461-6152

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	12/03/2024

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