Provider Demographics
NPI:1013178839
Name:ALBERTO B ALONSO MD PA
Entity Type:Organization
Organization Name:ALBERTO B ALONSO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOVOA-VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-596-4465
Mailing Address - Street 1:7101 SW 99TH AVE
Mailing Address - Street 2:SUITE 109-A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4661
Mailing Address - Country:US
Mailing Address - Phone:305-596-4465
Mailing Address - Fax:305-596-4495
Practice Address - Street 1:7101 SW 99TH AVE
Practice Address - Street 2:SUITE 109-A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4661
Practice Address - Country:US
Practice Address - Phone:305-596-4465
Practice Address - Fax:305-596-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83960208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6931Medicare PIN
FLH60678Medicare UPIN