Provider Demographics
NPI:1235136466
Name:ALONSO, NORMA URSA (MD)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:URSA
Last Name:ALONSO
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:AVE. PONCE DE LEON 735
Mailing Address - Street 2:TORRE AUXILIO MUTUO SUITE 519
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-759-5122
Mailing Address - Fax:787-753-4797
Practice Address - Street 1:AVE. PONCE DE LEON 735
Practice Address - Street 2:TORRE AUXILIO MUTUO SUITE 519
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917
Practice Address - Country:US
Practice Address - Phone:787-759-5122
Practice Address - Fax:787-753-4797
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12164207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0088561Medicare ID - Type UnspecifiedPROVIDER NUMBER