Basic Information
| Provider Information | |||||||||
| NPI: | 1649429291 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOSA PEREZ | ||||||||
| FirstName: | ALINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11501 SW 40TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331653313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056463716 | ||||||||
| FaxNumber: | 3056313828 | ||||||||
| Practice Location | |||||||||
| Address1: | 11501 SW 40TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331653313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056463716 | ||||||||
| FaxNumber: | 3056313828 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2008 | ||||||||
| LastUpdateDate: | 07/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW 1110 | FL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | SW1110 | 01 | FL | FL DEPT OF HEALTH | OTHER |