Provider Demographics
NPI:1326919440
Name:ANDARCIO, ALEX
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:ANDARCIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8324 COMMERCE WAY UNIT 822
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1626
Mailing Address - Country:US
Mailing Address - Phone:305-712-0775
Mailing Address - Fax:
Practice Address - Street 1:8324 COMMERCE WAY UNIT 822
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1626
Practice Address - Country:US
Practice Address - Phone:305-712-0775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA614828073000106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty