Provider Demographics
NPI:1215034947
Name:ALONSO, HELVIO (MD)
Entity Type:Individual
Prefix:
First Name:HELVIO
Middle Name:
Last Name:ALONSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13931 SW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7006
Mailing Address - Country:US
Mailing Address - Phone:305-223-9800
Mailing Address - Fax:305-223-9810
Practice Address - Street 1:1401 SW 107TH AVE
Practice Address - Street 2:301J
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2524
Practice Address - Country:US
Practice Address - Phone:305-223-9800
Practice Address - Fax:305-223-9810
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82141208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH42250Medicare UPIN
FLE5831SMedicare PIN