Provider Demographics
NPI:1043772155
Name:ALONZO, AARON ANDY (LNMT, PHD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:ANDY
Last Name:ALONZO
Suffix:
Gender:M
Credentials:LNMT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16301 SW 145TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1733
Mailing Address - Country:US
Mailing Address - Phone:786-897-0289
Mailing Address - Fax:
Practice Address - Street 1:16301 SW 145TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1733
Practice Address - Country:US
Practice Address - Phone:786-897-0289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA92236225700000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist