Provider Demographics
NPI:1073123816
Name:ALONSO MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ALONSO MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAILYN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALONSO PERDOMO
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:786-340-8377
Mailing Address - Street 1:11398 W FLAGLER ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1158
Mailing Address - Country:US
Mailing Address - Phone:786-340-8377
Mailing Address - Fax:
Practice Address - Street 1:11398 W FLAGLER ST STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1158
Practice Address - Country:US
Practice Address - Phone:786-340-8377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health