Provider Demographics
NPI:1164507588
Name:ALCAZAREN, EUGENIO GONZALEZ (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIO
Middle Name:GONZALEZ
Last Name:ALCAZAREN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1144 TALLEVAST RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-3267
Mailing Address - Country:US
Mailing Address - Phone:941-312-7552
Mailing Address - Fax:941-870-8054
Practice Address - Street 1:1144 TALLEVAST RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-3267
Practice Address - Country:US
Practice Address - Phone:941-312-7552
Practice Address - Fax:941-870-8054
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 44379208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064737300Medicaid
FL064737300Medicaid