Provider Demographics
NPI:1780632612
Name:CHILITO, ALICIA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:CHILITO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18425 NW 2ND AVENUE 5TH FLOOR PH7
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169
Mailing Address - Country:US
Mailing Address - Phone:800-434-1366
Mailing Address - Fax:786-955-6110
Practice Address - Street 1:18425 NW 2ND AVENUE 5TH FLOOR PH7
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169
Practice Address - Country:US
Practice Address - Phone:800-434-1366
Practice Address - Fax:786-955-6110
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0074131207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252652200Medicaid
FL252652200Medicaid
FLK6303BMedicare PIN