Provider Demographics
NPI:1265486864
Name:TIRADO, ALFREDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:
Last Name:TIRADO
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 1:4432 TWINVIEW LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6055
Mailing Address - Country:US
Mailing Address - Phone:407-432-3205
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:POTTER 225
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-444-5120
Practice Address - Fax:401-444-4307
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICMD12095207P00000X
FLME99543207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7058591Medicaid
RII55227Medicare UPIN
RI007058591Medicare ID - Type Unspecified