MEDICARE: ALFA MEDICAL CENTER 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1699608901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFA MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	9245 SW 158TH LN STE 201
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-1804
Country	:	US
Telephone Number	:	305-564-8836
Fax Number	:	305-564-8846

Provider Business Practice Location Address
First Line	:	9245 SW 158TH LN STE 201
Second Line	:
City	:	PALMETTO BAY
State	:	FL
Zip	:	33157-1804
Country	:	US
Telephone Number	:	305-564-8836
Fax Number	:	305-564-8846

Authorized Official
Title or Position	:	OWNER
Name	:	DAYANA REVUELTA NAVARRO
Credential	:
Telephone Number	:	305-564-8836

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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Directions to “ALFA MEDICAL CENTER CORP ” Practice Location

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