MEDICARE: JUAN CARLOS ALEA GARCIA

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	171W00000X	Contractor		FL
2	106S00000X	Behavior Technician	20-129044	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730696048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN CARLOS ALEA GARCIA

Provider Business Mailing Address
First Line	:	3881 W FLAGLER ST APT 202
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1645
Country	:	US
Telephone Number	:	786-372-5054
Fax Number	:

Provider Business Practice Location Address
First Line	:	3881 W FLAGLER ST APT 202
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1645
Country	:	US
Telephone Number	:	786-372-5054
Fax Number	:

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

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	01/26/2026

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